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Diagnoses of \u201chydrocephalus\u201d and \u201cepilepsy\u201d were identified through ICD-10-coded health records, excluding congenital and secondary cases. The association between these two diseases was investigated using logistic regression (adjusted for age and sex); subsequently, we performed a sampled cohort study to evaluate the hazard ratio (HR) for incident epilepsy in people with adult-onset hydrocephalus using Cox proportional hazards models with a dedicated sensitivity analysis including different sets of covariates such as demographic, lifestyle, vascular, and genetic factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Our cohort included 483,790 controls, 5,028 individuals with epilepsy, and 320 with adult-onset hydrocephalus. Hydrocephalus and epilepsy were strongly associated (OR: 9.6, 95% CI: 6.4\u201313.8,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Adjusted Cox models demonstrated a markedly increased risk of incident epilepsy in people with adult-onset hydrocephalus, with HR values ranging from 14.62 (95% CI: 7.91\u201327.00,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) to 23.80 (95% CI: 12.87\u201344.03,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) across models, after adjusting for multiple covariates. Results were also consistent after excluding people with comorbid neurodegenerative dementias such as Alzheimer\u2019s disease.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We demonstrated a markedly increased risk of epilepsy in adult-onset hydrocephalus, independent of vascular and neurodegenerative comorbidities and not attributable to shunt-related complications. These findings underscore the importance of increased diagnostic vigilance, as seizures may be under-recognized in this population, and support further research to clarify mechanisms and optimize management strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10072-026-09227-6","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T02:22:32Z","timestamp":1784168552000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Risk of epilepsy in people with adult-onset hydrocephalus: insights from the UK Biobank"],"prefix":"10.1007","volume":"47","author":[{"given":"Jolanda","family":"Buonocore","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8395-7809","authenticated-orcid":false,"given":"Francesco","family":"Fortunato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Fratto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Sammarra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Gambardella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aldo","family":"Quattrone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Quattrone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,16]]},"reference":[{"key":"9227_CR1","doi-asserted-by":"publisher","first-page":"jnnp","DOI":"10.1136\/jnnp-2025-336076","volume":"30","author":"A Bubenikova","year":"2025","unstructured":"Bubenikova A, Proch\u00e1zka V, Vac\u00ednek D et al (2025) From the past to the present: Evolving theories in the pathophysiology of normal pressure hydrocephalus. 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