{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T02:09:19Z","timestamp":1775441359972,"version":"3.50.1"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T00:00:00Z","timestamp":1775433600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T00:00:00Z","timestamp":1775433600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Acta Neurol Belg"],"DOI":"10.1007\/s13760-026-03057-1","type":"journal-article","created":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T01:05:12Z","timestamp":1775437512000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond Hakim\u2019s triad: a systematic review of atypical clinical manifestations in idiopathic normal pressure hydrocephalus"],"prefix":"10.1007","author":[{"given":"Giuseppe","family":"Demichele","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Graziano","family":"Taddei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edvige","family":"Iaboni","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariasole","family":"Gagliano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfredo","family":"De Vito","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angelo","family":"Pompucci","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianpaolo","family":"Petrella","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,4,6]]},"reference":[{"issue":"1\u20132","key":"3057_CR1","doi-asserted-by":"publisher","first-page":"15","DOI":"10.3238\/arztebl.2012.0015","volume":"109","author":"M Kiefer","year":"2012","unstructured":"Kiefer M, Unterberg A (2012) The differential diagnosis and treatment of normal-pressure hydrocephalus. Dtsch Arztebl Int 109(1\u20132):15\u201325 quiz 26. https:\/\/doi.org\/10.3238\/arztebl.2012.0015","journal-title":"Dtsch Arztebl Int"},{"issue":"5","key":"3057_CR2","doi-asserted-by":"publisher","first-page":"e0217705","DOI":"10.1371\/journal.pone.0217705","volume":"14","author":"J Andersson","year":"2019","unstructured":"Andersson J, Rosell M, Kockum K, Lilja-Lund O, S\u00f6derstr\u00f6m L, Laurell K (2019) Prevalence of idiopathic normal pressure hydrocephalus: A prospective, population-based study. PLoS ONE 14(5):e0217705. https:\/\/doi.org\/10.1371\/journal.pone.0217705PMID: 31141553; PMCID: PMC6541279","journal-title":"PLoS ONE"},{"issue":"2","key":"3057_CR3","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1111\/ane.13182","volume":"141","author":"V Zaccaria","year":"2020","unstructured":"Zaccaria V, Bacigalupo I, Gervasi G, Canevelli M, Corbo M, Vanacore N, Lacorte E (2020) A systematic review on the epidemiology of normal pressure hydrocephalus. Acta Neurol Scand 141(2):101\u2013114. https:\/\/doi.org\/10.1111\/ane.13182Epub 2019 Nov 21. PMID: 31622497","journal-title":"Acta Neurol Scand"},{"issue":"6","key":"3057_CR4","doi-asserted-by":"publisher","first-page":"2002","DOI":"10.1016\/j.wneu.2015.07.005","volume":"84","author":"R Mart\u00edn-L\u00e1ez","year":"2015","unstructured":"Mart\u00edn-L\u00e1ez R, Caballero-Arzapalo H, L\u00f3pez-Men\u00e9ndez L\u00c1, Arango-Lasprilla JC, V\u00e1zquez-Barquero A (2015) Epidemiology of Idiopathic Normal Pressure Hydrocephalus: A Systematic Review of the Literature. World Neurosurg 84(6):2002\u20132009. https:\/\/doi.org\/10.1016\/j.wneu.2015.07.005Epub 2015 Jul 14. PMID: 26183137","journal-title":"World Neurosurg"},{"key":"3057_CR5","doi-asserted-by":"publisher","unstructured":"Taddei G, Demichele G, Failla Mulone M, Gagliano M, Pesce A, Ciarlo S, Iaboni E, Pompucci A, Petrella G Normal pressure hydrocephalus does not matter: an Italian perspective. J Neurosurg Sci. 2024 Jul 9. https:\/\/doi.org\/10.23736\/S0390-5616.24.06257-X. Epub ahead of print. PMID: 38980303","DOI":"10.23736\/S0390-5616.24.06257-X"},{"key":"3057_CR6","doi-asserted-by":"crossref","unstructured":"Petrella G, Demichele G, Armocida D, Taddei G, Frati A, Pompucci A, Pesce A Idiopathic normal pressure hydrocephalus: A critical analysis of its underrepresentation across Italian medical-scientific societies in the last 5 years. Neurocirugia (Astur: Engl Ed). 2024 Nov 19:S2529-8496(24)00073-X. doi: 10.1016\/j.neucie.2024.11.007. Epub ahead of print. PMID: 39566844","DOI":"10.1016\/j.neucie.2024.11.007"},{"key":"3057_CR7","doi-asserted-by":"publisher","unstructured":"Taddei G, Demichele G, Failla Mulone M, Gagliano M, Carocci L, Pesce A, Ciarlo S, Iaboni E, Pompucci A, Petrella G Normal pressure hydrocephalus does not matter: a European perspective. J Neurosurg Sci. 2024 Dec 17. https:\/\/doi.org\/10.23736\/S0390-5616.24.06383-5. Epub ahead of print. PMID: 39688603","DOI":"10.23736\/S0390-5616.24.06383-5"},{"key":"3057_CR8","doi-asserted-by":"publisher","unstructured":"Hakim S, Adams RD (1965) Jul-Aug;2(4):307\u2009\u2013\u200927 The special clinical problem of symptomatic hydrocephalus with normal cerebrospinal fluid pressure. Observations on cerebrospinal fluid hydrodynamics. J Neurol Sci. https:\/\/doi.org\/10.1016\/0022-510x(65)90016-x. PMID: 5889177","DOI":"10.1016\/0022-510x(65)90016-x"},{"issue":"3","key":"3057_CR9","doi-asserted-by":"publisher","first-page":"165","DOI":"10.3233\/BEN-2009-0233","volume":"21","author":"Y Kito","year":"2009","unstructured":"Kito Y, Kazui H, Kubo Y, Yoshida T, Takaya M, Wada T, Nomura K, Hashimoto M, Ohkawa S, Miyake H, Ishikawa M, Takeda M (2009) Neuropsychiatric symptoms in patients with idiopathic normal pressure hydrocephalus. Behav Neurol 21(3):165\u2013174. https:\/\/doi.org\/10.3233\/BEN-2009-0233PMID: 19996513; PMCID: PMC5444276","journal-title":"Behav Neurol"},{"key":"3057_CR10","doi-asserted-by":"publisher","unstructured":"Schneider U, Malmadier A, Dengler R, Sollmann WP, Emrich HM (1996) Mood cycles associated with normal pressure hydrocephalus. Am J Psychiatry. ;153(10):1366-7. https:\/\/doi.org\/10.1176\/ajp.153.10.1366. PMID: 8831453","DOI":"10.1176\/ajp.153.10.1366"},{"key":"3057_CR11","doi-asserted-by":"publisher","unstructured":"Todisco M, Valentino F, Alfonsi E, Cosentino G (2022) Camptocormia in idiopathic normal pressure hydrocephalus: a case report. Acta Neurol Belg. ;122(4):1127\u20131129. https:\/\/doi.org\/10.1007\/s13760-021-01666-6. Epub 2021 Apr 3. PMID: 33811617","DOI":"10.1007\/s13760-021-01666-6"},{"issue":"2","key":"3057_CR12","doi-asserted-by":"publisher","first-page":"e55239","DOI":"10.7759\/cureus.55239","volume":"16","author":"PB Ferguson","year":"2024","unstructured":"Ferguson PB, Snavely K (2024) Palinopsia in the Setting of Normal Pressure Hydrocephalus. Cureus 16(2):e55239. https:\/\/doi.org\/10.7759\/cureus.55239PMID: 38558696; PMCID: PMC10981441","journal-title":"Cureus"},{"key":"3057_CR13","doi-asserted-by":"publisher","first-page":"106099","DOI":"10.1016\/j.clineuro.2020.106099","volume":"197","author":"RM Naylor","year":"2020","unstructured":"Naylor RM, Lenartowicz KA, Graff-Radford J, Jones DT, Cutsforth-Gregory JK, Graff-Radford NR, Elder BD (2020) High prevalence of cervical myelopathy in patients with idiopathic normal pressure hydrocephalus. Clin Neurol Neurosurg 197:106099. https:\/\/doi.org\/10.1016\/j.clineuro.2020.106099Epub 2020 Jul 17. PMID: 32702575","journal-title":"Clin Neurol Neurosurg"},{"issue":"2","key":"3057_CR14","doi-asserted-by":"publisher","first-page":"1007","DOI":"10.1007\/s00415-021-10687-3","volume":"269","author":"A Mechelli","year":"2022","unstructured":"Mechelli A, Quattrone A, Nistic\u00f2 R, Cras\u00e0 M, La Torre D, Vescio B, Quattrone A (2022) Blink reflex recovery cycle distinguishes patients with idiopathic normal pressure hydrocephalus from elderly subjects. J Neurol 269(2):1007\u20131012. https:\/\/doi.org\/10.1007\/s00415-021-10687-3Epub 2021 Jul 2. PMID: 34213613","journal-title":"J Neurol"},{"key":"3057_CR15","doi-asserted-by":"publisher","first-page":"n71","DOI":"10.1136\/bmj.n71","volume":"372","author":"MJ Page","year":"2021","unstructured":"Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Brennan SE, Chou R, Glanville J, Grimshaw JM, Hr\u00f3bjartsson A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S, McGuinness LA, Stewart LA, Thomas J, Tricco AC, Welch VA, Whiting P, Moher D (2021) The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 372:n71. https:\/\/doi.org\/10.1136\/bmj.n71PMID: 33782057; PMCID: PMC8005924","journal-title":"BMJ"},{"key":"3057_CR16","doi-asserted-by":"publisher","unstructured":"Mathew R, Archana NU, Sheetal S (2021) Sep-Oct;69(5):1356\u20131358 Idiopathic Normal Pressure Hydrocephalus Presenting as Psychosis. Neurol India. https:\/\/doi.org\/10.4103\/0028-3886.329621. PMID: 34747812","DOI":"10.4103\/0028-3886.329621"},{"key":"3057_CR17","doi-asserted-by":"publisher","unstructured":"Onder H (2020) Normal Pressure Hydrocephalus with Primary Presentation of Psychiatric Disturbance? J Neurol Surg A Cent Eur Neurosurg. 81(4):377\u2013378. https:\/\/doi.org\/10.1055\/s-0039-3402772. Epub 2020 Mar 6. PMID: 32143227","DOI":"10.1055\/s-0039-3402772"},{"key":"3057_CR18","doi-asserted-by":"publisher","unstructured":"Manoj PM, Alam MR (2024) Normal pressure hydrocephalus disguising psychosis: a case report. East Asian Arch Psychiatry. ;34(2):45\u201347. https:\/\/doi.org\/10.12809\/eaap2357. PMID: 38955791","DOI":"10.12809\/eaap2357"},{"issue":"6","key":"3057_CR19","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1590\/0004-282x20140047","volume":"72","author":"MF Oliveira","year":"2014","unstructured":"Oliveira MF, Oliveira JR, Rotta JM, Pinto FC (2014) Psychiatric symptoms are present in most of the patients with idiopathic normal pressure hydrocephalus. Arq Neuropsiquiatr 72(6):435\u2013438. https:\/\/doi.org\/10.1590\/0004-282x20140047PMID: 24964110","journal-title":"Arq Neuropsiquiatr"},{"issue":"5","key":"3057_CR20","first-page":"154","volume":"19","author":"L Adler","year":"1992","unstructured":"Adler L, R\u00e4der K, Kolenda H (1992) Endogeniforme affektive Psychosen und Normaldruckhydrozephalus [Endogeniform affective psychoses and normal pressure hydrocephalus]. Psychiatr Prax 19(5):154\u2013156 German. PMID: 1438609","journal-title":"Psychiatr Prax"},{"key":"3057_CR21","doi-asserted-by":"crossref","unstructured":"T\u00fcnel M, \u00c7akmak S, Tamam L, Demir T (2019 ) A Case of Simultaneous Mania and Idiopathic Normal Pressure Hydrocephalus: Etiology or Comorbidity? Turk Psikiyatri Derg. 30(4):290\u2013294 English, Turkish. PMID: 32594492","DOI":"10.5080\/u23340"},{"key":"3057_CR22","doi-asserted-by":"publisher","unstructured":"Kwentus JA, Hart RP (1987) Normal pressure hydrocephalus presenting as mania. J Nerv Ment Dis. ;175(8):500-2. https:\/\/doi.org\/10.1097\/00005053-198708000-00010. PMID: 3625191","DOI":"10.1097\/00005053-198708000-00010"},{"key":"3057_CR23","doi-asserted-by":"crossref","unstructured":"Nagaratnam N, Verma S, Nagaratnam K, Sahasrabudde R, Koumoukeus H, Tan PT (1994 ) Psychiatric and behavioural manifestations of normal-pressure hydrocephalus. Br J Clin Pract 48(3):122\u2013124 PMID: 8031685","DOI":"10.1111\/j.1742-1241.1994.tb09780.x"},{"issue":"1","key":"3057_CR24","first-page":"71","volume":"44","author":"VK Chopra","year":"2002","unstructured":"Chopra VK, Sinha VK, Das S (2002) Normal pressure hydrocephalus presenting as psychotic depression: moderately successful treatment with a course of ect & pharmacotherapy : a case report. Indian J Psychiatry 44(1):71\u201375 PMID: 21206886; PMCID: PMC2953659","journal-title":"Indian J Psychiatry"},{"key":"3057_CR25","doi-asserted-by":"publisher","unstructured":"Rosen H, Swigar ME (1976) Depression and normal pressure hydrocephalus. A dilemma in neuropsychiatric differential diagnosis. J Nerv Ment Dis. ;163(1):35\u201340. https:\/\/doi.org\/10.1097\/00005053-197607000-00005. PMID: 932710","DOI":"10.1097\/00005053-197607000-00005"},{"key":"3057_CR26","doi-asserted-by":"publisher","unstructured":"Lying-Tunell U (1979) Psychotic symptoms in normal-pressure hydrocephalus. Acta Psychiatr Scand. ;59(4):415-9. https:\/\/doi.org\/10.1111\/j.1600-0447.1979.tb04483.x. PMID: 433632","DOI":"10.1111\/j.1600-0447.1979.tb04483.x"},{"key":"3057_CR27","doi-asserted-by":"publisher","unstructured":"Yusim A, Anbarasan D, Bernstein C, Boksay I, Dulchin M, Lindenmayer JP, Saavedra-Velez C, Shapiro M, Sadock B (2008) Normal pressure hydrocephalus presenting as Othello syndrome: case presentation and review of the literature. Am J Psychiatry. ;165(9):1119-25. https:\/\/doi.org\/10.1176\/appi.ajp.2008.07111820. PMID: 18765494","DOI":"10.1176\/appi.ajp.2008.07111820"},{"key":"3057_CR28","doi-asserted-by":"publisher","unstructured":"Chankaew E, Srirabheebhat P, Manochiopinig S, Witthiwej T, Benjamin I (2016) Bulbar dysfunction in normal pressure hydrocephalus: a prospective study. Neurosurg Focus. ;41(3):E15. https:\/\/doi.org\/10.3171\/2016.6.FOCUS16183. PMID: 27581311","DOI":"10.3171\/2016.6.FOCUS16183"},{"key":"3057_CR29","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1016\/j.wneu.2019.11.152","volume":"135","author":"P Mathew","year":"2020","unstructured":"Mathew P, Chiu L, Lee C, Carroll R, Johnson MD (2020) Idiopathic Normal Pressure Hydrocephalus With Stuttering: Report of Two Cases and Review of the Literature. World Neurosurg 135:176\u2013179. https:\/\/doi.org\/10.1016\/j.wneu.2019.11.152Epub 2019 Dec 2. PMID: 31805405; PMCID: PMC8424911","journal-title":"World Neurosurg"},{"key":"3057_CR30","doi-asserted-by":"publisher","unstructured":"Lee JY, Im K, Kwon KY (2018) Unusual case of idiopathic normal pressure hydrocephalus initially presenting as Parinaud\u2019s syndrome. Geriatr Gerontol Int. ;18(7):1136\u20131137. https:\/\/doi.org\/10.1111\/ggi.13333. PMID: 30133969","DOI":"10.1111\/ggi.13333"},{"issue":"1","key":"3057_CR31","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1016\/j.oftal.2017.06.011","volume":"93","author":"VM Asensio-S\u00e1nchez","year":"2018","unstructured":"Asensio-S\u00e1nchez VM, Mart\u00edn-Prieto A (2018) Colour vision abnormality as the only manifestation of normal pressure hydrocephalus. Arch Soc Esp Oftalmol (Engl Ed) 93(1):35\u201337 English, Spanish. https:\/\/doi.org\/10.1016\/j.oftal.2017.06.011","journal-title":"Arch Soc Esp Oftalmol (Engl Ed)"},{"issue":"1\u20132","key":"3057_CR32","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1016\/j.jns.2014.11.002","volume":"347","author":"AT Hill","year":"2014","unstructured":"Hill AT, Cowey MW, Williams DR (2014) A case of shunt responsive tremor due to normal pressure hydrocephalus. J Neurol Sci 347(1\u20132):413\u2013415. https:\/\/doi.org\/10.1016\/j.jns.2014.11.002Epub 2014 Nov 8. PMID: 25467145","journal-title":"J Neurol Sci"},{"key":"3057_CR33","doi-asserted-by":"publisher","unstructured":"Zhang J, Williams MA, Rigamonti D (2008) Heritable essential tremor-idiopathic normal pressure hydrocephalus (ETINPH). Am J Med Genet A. ;146A(4):433-9. https:\/\/doi.org\/10.1002\/ajmg.a.31958. PMID: 18203159","DOI":"10.1002\/ajmg.a.31958"},{"key":"3057_CR34","doi-asserted-by":"publisher","unstructured":"Kehler U, Petersen S (2023) Prevalence of Fecal Incontinence in Normal Pressure Hydrocephalus: A Prospective Evaluation of 100 Patients. World Neurosurg. ;178:e1-e5. https:\/\/doi.org\/10.1016\/j.wneu.2023.07.120. Epub 2023 Jul 31. PMID: 37532018","DOI":"10.1016\/j.wneu.2023.07.120"},{"key":"3057_CR35","doi-asserted-by":"publisher","unstructured":"Jung KH, Chu K, Jeong SW, Hong YH, Park KI, Roh JK (2003) Idiopathic normal pressure hydrocephalus predominantly with prolonged fever and hyponatremia. Neurology. ;61(4):554-6. https:\/\/doi.org\/10.1212\/01.wnl.0000078196.83215.4d. PMID: 12939438","DOI":"10.1212\/01.wnl.0000078196.83215.4d"},{"key":"3057_CR36","doi-asserted-by":"publisher","unstructured":"Yoshino M, Yoshimi Y, Taniguchi M, Nakamura S, Ikeda T (1999) Syndrome of inappropriate secretion of antidiuretic hormone associated with idiopathic normal pressure hydrocephalus. Intern Med. ;38(3):290-2. https:\/\/doi.org\/10.2169\/internalmedicine.38.290. PMID: 10337945","DOI":"10.2169\/internalmedicine.38.290"},{"key":"3057_CR37","doi-asserted-by":"publisher","unstructured":"Blomsterwall E, Svantesson U, Carlsson U, Tullberg M, Wikkels\u00f6 C (2000) Postural disturbance in patients with normal pressure hydrocephalus. Acta Neurol Scand. ;102(5):284\u2009\u2013\u200991. https:\/\/doi.org\/10.1034\/j.1600-0404.2000.102005284.x. PMID: 11083504","DOI":"10.1034\/j.1600-0404.2000.102005284.x"},{"key":"3057_CR38","doi-asserted-by":"publisher","unstructured":"Price TR, Tucker GJ (1977) Psychiatric and behavioral manifestations of normal pressure hydrocephalus. A case report and brief review. J Nerv Ment Dis. ;164(1):51\u2009\u2013\u20095. https:\/\/doi.org\/10.1097\/00005053-197701000-00009. PMID: 830802","DOI":"10.1097\/00005053-197701000-00009"}],"container-title":["Acta Neurologica Belgica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s13760-026-03057-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s13760-026-03057-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s13760-026-03057-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T01:05:14Z","timestamp":1775437514000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s13760-026-03057-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,6]]},"references-count":38,"alternative-id":["3057"],"URL":"https:\/\/doi.org\/10.1007\/s13760-026-03057-1","relation":{},"ISSN":["0300-9009","2240-2993"],"issn-type":[{"value":"0300-9009","type":"print"},{"value":"2240-2993","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,6]]},"assertion":[{"value":"9 January 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 March 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 April 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in this article.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosures"}}]}}