Normal-pressure hydrocephalus
ICD-10 G91.2 · ICD-11 8D64.04

What Is the Treatment of Normal-Pressure Hydrocephalus (iNPH)?

Normal-pressure hydrocephalus (iNPH) is a treatable syndrome. Because it responds to a specific surgical intervention, timely identification and structured management are central to achieving meaningful clinical improvement.

Clinical Goals

Successful treatment is defined by measurable improvement in the three core symptom domains of iNPH:

Gait disturbance Dementia Urinary incontinence

Treatment Approach

The established approach centres on a surgical CSF shunt procedure — a neurosurgical intervention designed to redirect cerebrospinal fluid — selected and configured according to specific intraoperative and post-operative criteria.

Full valve selection, pressure settings, and peri-operative protocol available in the structured regimen →
Instant Access to Structured Evidence-Based Regimens

References

  1. CSF shunt intervention is effective for treating iNPH.
  2. Surgical methods applied for iNPH treatment, similar to the general surgical methods for communicating hydrocephalus, are shunt interventions with ventriculo-peritoneal (VP), ventriculo-atrial (VA), or lumbo-peritoneal (LP) shunts, and they are effective.
  3. A programmable-pressure valve is recommended.
  4. If intracranial hypotension is detected, a mechanism (anti-siphon/gravity device, etc.) to prevent excessive drainage should be added.
  5. iNPH is a syndrome that causes gait disturbance, dementia, and urinary incontinence that can be improved with standard CSF shunt intervention; that is, iNPH is a treatable disease.
  6. Symptoms usually improve after surgical intervention.

DOI: 10.2176/nmc.st.2020-0292

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