How can you best diagnose idiopathic normal pressure hydrocephalus?

Abstract

Diagnose idiopathic normal pressure hydrocephalus (INPH) by clinical history, brain imaging, physical findings, and physiological criteria. The clinical examination must show the characteristic gait disturbance and either impaired cognition or impaired urinary continence (strength of recommendation [SOR]: B, based on systematic review of small randomized controlled trial [RCT] and prospective trials). The cerebrospinal fluid (CSF) opening pressure should be between 70 and 245 mm H2O (SOR: B, based on systematic review of small RCT and prospective trials). No single test has sufficient sensitivity to rule out the diagnosis of INPH (SOR: B, based on systematic review of small RCT and prospective trials).