{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T12:12:35Z","timestamp":1790856755951,"version":"4.1.0"},"reference-count":166,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2016,9]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>There are several etiologies that can lead to the development of secondary normal pressure hydrocephalus (sNPH). The aim of this study was to evaluate the etiology, diagnosis, treatment, and outcome in patients with sNPH and to highlight important differences between the separate etiologies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A comprehensive review of the literature was performed to identify studies conducted between 1965 and 2015 that included data regarding the etiology, treatment, diagnosis, and outcome in patients with sNPH. Sixty-four studies with a total of 1309 patients were included. The inclusion criteria of this study were articles that were written in English, included more than 2 patients with the diagnosis of sNPH, and contained data regarding the etiology, diagnosis, treatment, or outcome of NPH. The most common assessment of clinical improvement was based on the Stein and Langfitt grading scale or equivalent improvement on other alternative ordinal grading scales.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>The main etiologies of sNPH were subarachnoid hemorrhage (SAH) in 46.5%, head trauma in 29%, intracranial malignancies in 6.2%, meningoencephalitis in 5%, and cerebrovascular disease in 4.5% of patients. In 71.9% of patients the sNPH was treated with ventriculoperitoneal shunt placement, and 24.4% had placement of a ventriculoatrial shunt. Clinical improvement after shunt placement was reported in 74.4% and excellent clinical improvement in 58% of patients with sNPH. The mean follow-up period after shunt placement was 13 months. Improvement was seen in 84.2% of patients with SAH, 83% of patients with head trauma, 86.4% of patients with brain tumors, 75% of patients with meningoencephalitis, and 64.7% of patients with NPH secondary to stroke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Secondary NPH encompasses a diverse group of clinical manifestations associated with a subset of patients with acquired hydrocephalus. The most common etiologies of sNPH include SAH and traumatic brain injury. Secondary NPH does indeed exist, and should be differentiated from idiopathic NPH based on outcome and on clinical, pathophysiological, and epidemiological characteristics, but should not be considered as a separate entity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2016.6.focus16189","type":"journal-article","created":{"date-parts":[[2016,9,1]],"date-time":"2016-09-01T03:39:30Z","timestamp":1472701170000},"page":"E6","source":"Crossref","is-referenced-by-count":63,"title":["Revisiting secondary normal pressure hydrocephalus: does it exist? A review"],"prefix":"10.3171","volume":"41","author":[{"given":"Badih","family":"Daou","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra","family":"Klinge","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The Warren Alpert Medical School of Brown University, Rhode Island Hospital, Providence, Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stavropoula","family":"Tjoumakaris","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert H.","family":"Rosenwasser","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal","family":"Jabbour","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-focus16189","series-title":"N Engl J Med","first-page":"117","article-title":"Symptomatic occult hydrocephalus with \u201cnormal\u201d cerebrospinal-fluid pressure. A treatable syndrome","volume":"273","author":"Adams","year":"1965"},{"key":"b2-focus16189","series-title":"Acta Neurochir (Wien)","first-page":"1","article-title":"Surgical indications in normotensive hydrocephalus. A retrospective analysis of the relations of some diagnostic findings to the results of surgical treatment","volume":"33","author":"Belloni","year":"1976"},{"issue":"3 Suppl","key":"b3-focus16189","series-title":"Neurosurgery","first-page":"S29","article-title":"Surgical management of idiopathic normal-pressure hydrocephalus","volume":"57","author":"Bergsneider","year":"2005"},{"key":"b4-focus16189","series-title":"Acta Neurochir (Wien)","first-page":"1","article-title":"Conductance to outflow of CSF in normal pressure hydrocephalus","volume":"71","author":"B\u00f8rgesen","year":"1984"},{"key":"b5-focus16189","series-title":"Brain","first-page":"65","article-title":"The predictive value of conductance to outflow of CSF in normal pressure hydrocephalus","volume":"105","author":"B\u00f8rgesen","year":"1982"},{"key":"b6-focus16189","series-title":"AJNR Am J Neuroradiol","first-page":"1586","article-title":"Normal pressure hydrocephalus: new concepts on etiology and diagnosis","volume":"21","author":"Bradley","year":"2000"},{"issue":"4","key":"b7-focus16189","series-title":"Neurosurg Focus","first-page":"e8","article-title":"Management of patients with normal-pressure hydrocephalus by using lumboperitoneal shunt system with the Codman Hakim programmable valve","volume":"7","author":"Chang","year":"1999"},{"key":"b8-focus16189","series-title":"Neurol Med Chir (Tokyo)","first-page":"841","article-title":"Prediction of effectiveness of shunting in patients with normal pressure hydrocephalus by cerebral blood flow measurement and computed tomography cisternography","volume":"39","author":"Chang","year":"1999"},{"key":"b9-focus16189","series-title":"J Neurol Neurosurg Psychiatry","first-page":"1430","article-title":"Effectiveness of shunting in patients with normal pressure hydrocephalus predicted by temporary, controlled-resistance, continuous lumbar drainage: a pilot study","volume":"57","author":"Chen","year":"1994"},{"key":"b10-focus16189","series-title":"Top Stroke Rehabil","first-page":"330","article-title":"Rehabilitation of patients with chronic normal-pressure hydrocephalus after aneurysmal subarachnoid hemorrhage benefits from ventriculoperitoneal shunt","volume":"16","author":"Chen","year":"2009"},{"key":"b11-focus16189","series-title":"Acta Neurochir (Wien)","first-page":"1141","article-title":"Changes in intracranial pulse pressure amplitudes after shunt implantation and adjustment of shunt valve opening pressure in normal pressure hydrocephalus","volume":"150","author":"Eide","year":"2008"},{"key":"b12-focus16189","series-title":"Int Rev Neurobiol","first-page":"263","article-title":"Normal pressure hydrocephalus","volume":"84","author":"Finney","year":"2009"},{"key":"b13-focus16189","series-title":"Clin Neurol Neurosurg","first-page":"223","article-title":"Chronic subdural haematoma: surgical treatment and outcome in 1000 cases","volume":"107","author":"Gelabert-Gonz\u00e1lez","year":"2005"},{"key":"b14-focus16189","series-title":"Acta Neurochir (Wien)","first-page":"79","article-title":"Resistance to cerebrospinal fluid outflow and intracranial pressure in patients with hydrocephalus after subarachnoid haemorrhage","volume":"88","author":"Gjerris","year":"1987"},{"key":"b15-focus16189","series-title":"Neurosurgery","first-page":"497","article-title":"Evaluation and treatment of patients with suspected normal pressure hydrocephalus on long-term warfarin anticoagulation therapy","volume":"60","author":"Goodwin","year":"2007"},{"key":"b16-focus16189","series-title":"J Neurol Neurosurg Psychiatry","first-page":"940","article-title":"Recovery in hydrocephalic dementia after shunt operation","volume":"41","author":"Gustafson","year":"1978"},{"key":"b17-focus16189","series-title":"J Neurol Sci","first-page":"307","article-title":"The special clinical problem of symptomatic hydrocephalus with normal cerebrospinal fluid pressure. Observations on cerebrospinal fluid hydrodynamics","volume":"2","author":"Hakim","year":"1965"},{"key":"b18-focus16189","series-title":"J Neurol Neurosurg Psychiatry","first-page":"630","article-title":"Differentiation of communicating hydrocephalus and presenile dementia by continuous recording of cerebrospinal fluid pressure","volume":"40","author":"Hartmann","year":"1977"},{"key":"b19-focus16189","series-title":"Neurol Med Chir (Tokyo)","first-page":"29","article-title":"Auditory brainstem responses before and after shunting in patients with suspected normal pressure hydrocephalus","volume":"30","author":"Hashimoto","year":"1990"},{"key":"b20-focus16189","series-title":"Neurosurgery","first-page":"1166","article-title":"Idiopathic normal pressure hydrocephalus: a systematic review of diagnosis and outcome","volume":"49","author":"Hebb","year":"2001"},{"key":"b21-focus16189","series-title":"Intracranial Pressure VIII","first-page":"842","article-title":"Idiopathic vs. post-SAH normal pressure hydrocephalus","author":"Hirai","year":"1993"},{"key":"b22-focus16189","series-title":"Neurol Med Chir (Tokyo)","first-page":"382","article-title":"Regional cerebral blood flow and oxygen metabolism in normal pressure hydrocephalus after subarachnoid hemorrhage","volume":"29","author":"Ishikawa","year":"1989"},{"key":"b23-focus16189","series-title":"J Neurol Neurosurg Psychiatry","first-page":"721","article-title":"Comparison between the lumbar infusion and CSF tap tests to predict outcome after shunt surgery in suspected normal pressure hydrocephalus","volume":"73","author":"Kahlon","year":"2002"},{"key":"b24-focus16189","series-title":"Neurol Med Chir (Tokyo)","first-page":"503","article-title":"Investigation of normal pressure hydrocephalus by 123I-IMP SPECT","volume":"31","author":"Kamiya","year":"1991"},{"key":"b25-focus16189","series-title":"Brain","first-page":"45","article-title":"Hydrocephalus in the adult following spontaneous subarachnoid haemorrhage","volume":"84","author":"Kibler","year":"1961"},{"key":"b26-focus16189","series-title":"Acta Neurochir Suppl","first-page":"364","article-title":"Outcome predictors for normal-pressure hydrocephalus","volume":"96","author":"Kiefer","year":"2006"},{"key":"b27-focus16189","series-title":"J Clin Neurosci","first-page":"729","article-title":"Predicting the outcome of shunt surgery in normal pressure hydrocephalus","volume":"14","author":"Kilic","year":"2007"},{"issue":"3 Suppl","key":"b28-focus16189","series-title":"Neurosurgery","first-page":"S40","article-title":"Outcome of shunting in idiopathic normal-pressure hydrocephalus and the value of outcome assessment in shunted patients","volume":"57","author":"Klinge","year":"2005"},{"key":"b29-focus16189","series-title":"Acta Neurochir (Wien)","first-page":"48","article-title":"Cerebrospinal fluid outflow resistance measurements in the selection of patients for shunt surgery in the normal pressure hydrocephalus syndrome. A controlled trial","volume":"104","author":"Kosteljanetz","year":"1990"},{"key":"b30-focus16189","series-title":"Acta Neurol Scand","first-page":"475","article-title":"Clinical parameters in 74 consecutive patients shunt operated for normal pressure hydrocephalus","volume":"84","author":"Larsson","year":"1991"},{"key":"b31-focus16189","series-title":"Med Sci Monit","first-page":"PR19","article-title":"Comparison of cerebrospinal fluid biomarkers between idiopathic normal pressure hydrocephalus and subarachnoid hemorrhage-induced chronic hydrocephalus: a pilot study","volume":"18","author":"Lee","year":"2012"},{"key":"b32-focus16189","series-title":"Neurology","first-page":"478","article-title":"Communicating hydrocephalus in adults. Diagnostic tests and results of treatment with medium pressure shunts","volume":"28","author":"Magnaes","year":"1978"},{"key":"b33-focus16189","series-title":"Stroke","first-page":"1074","article-title":"Cerebral blood flow in normal pressure hydrocephalus","volume":"18","author":"Mamo","year":"1987"},{"issue":"3 Suppl","key":"b34-focus16189","series-title":"Neurosurgery","first-page":"S17","article-title":"The value of supplemental prognostic tests for the preoperative assessment of idiopathic normal-pressure hydrocephalus","volume":"57","author":"Marmarou","year":"2005"},{"issue":"3 Suppl","key":"b35-focus16189","series-title":"Neurosurgery","first-page":"S1","article-title":"Development of guidelines for idiopathic normal-pressure hydrocephalus: introduction","volume":"57","author":"Marmarou","year":"2005"},{"key":"b36-focus16189","series-title":"J Neurosurg","first-page":"1026","article-title":"Posttraumatic ventriculomegaly: hydrocephalus or atrophy? A new approach for diagnosis using CSF dynamics","volume":"85","author":"Marmarou","year":"1996"},{"issue":"4","key":"b37-focus16189","series-title":"Neurosurg Focus","first-page":"E1","article-title":"Estimated incidence of normal pressure hydrocephalus and shunt outcome in patients residing in assisted-living and extended-care facilities","volume":"22","author":"Marmarou","year":"2007"},{"key":"b38-focus16189","series-title":"Acta Neurochir Suppl","first-page":"350","article-title":"Quantitative analysis of CSF flow dynamics using MRI in normal pressure hydrocephalus","volume":"71","author":"Mase","year":"1998"},{"key":"b39-focus16189","series-title":"Arch Neurol","first-page":"657","article-title":"Abnormal cerebrospinal fluid-blood flow dynamics. Implications in diagnosis, treatment, and prognosis in normal pressure hydrocephalus","volume":"32","author":"Mathew","year":"1975"},{"key":"b40-focus16189","series-title":"Surg Neurol","first-page":"396","article-title":"Cerebral hemodynamics in patients with normal pressure hydrocephalus: correlation between cerebral circulation time and dementia","volume":"34","author":"Matsuda","year":"1990"},{"key":"b41-focus16189","series-title":"J Neurosurg","first-page":"1458","article-title":"Should ventriculoatrial shunting be the procedure of choice for normal-pressure hydrocephalus?","volume":"120","author":"McGovern","year":"2014"},{"key":"b42-focus16189","series-title":"Neurosurgery","first-page":"484","article-title":"Treatment of normal pressure hydrocephalus with low versus medium pressure cerebrospinal fluid shunts","volume":"15","author":"McQuarrie","year":"1984"},{"key":"b43-focus16189","series-title":"J Neurosurg","first-page":"513","article-title":"Evaluation of treatment of normal-pressure hydrocephalus","volume":"62","author":"Meyer","year":"1985"},{"key":"b44-focus16189","series-title":"Eur J Nucl Med","first-page":"73","article-title":"Cortical perfusion assessment with 123I-isopropyl amphetamine (123I-IAMP) in normal pressure hydrocephalus (NPH)","volume":"14","author":"Moretti","year":"1988"},{"key":"b45-focus16189","series-title":"Acta Neurochir (Wien)","first-page":"255","article-title":"Quantitative local cerebral blood flow change after cerebrospinal fluid removal in patients with normal pressure hydrocephalus measured by a double injection method with N-isopropyl-p-[123I] iodoamphetamine","volume":"144","author":"Mori","year":"2002"},{"key":"b46-focus16189","series-title":"J Neurosurg","first-page":"279","article-title":"Further experience with the syndrome of \u201cnormal\u201d pressure hydrocephalus","volume":"31","author":"Ojemann","year":"1969"},{"key":"b47-focus16189","series-title":"J Cereb Blood Flow Metab","first-page":"17","article-title":"Normal pressure hydrocephalus and cerebral blood flow: a PET study of baseline values","volume":"24","author":"Owler","year":"2004"},{"key":"b48-focus16189","series-title":"Acta Neurochir (Wien)","first-page":"953","article-title":"The predictive value of external continuous lumbar drainage, with cerebrospinal fluid outflow controlled by medium pressure valve, in normal pressure hydrocephalus","volume":"147","author":"Panagiotopoulos","year":"2005"},{"key":"b49-focus16189","series-title":"Acta Neurochir (Wien)","first-page":"983","article-title":"Continuous intraventricular pressure monitoring for diagnosis of normal-pressure hydrocephalus","volume":"149","author":"Pfisterer","year":"2007"},{"key":"b50-focus16189","series-title":"Acta Neurochir Suppl","first-page":"169","article-title":"Postoperative changes in SPECT-rCBF in hydrocephalus","volume":"95","author":"Piechnik","year":"2005"},{"key":"b51-focus16189","series-title":"Neurosurgery","first-page":"1246","article-title":"Management of hydrocephalus associated with vestibular schwannoma and other cerebellopontine angle tumors","volume":"48","author":"Pirouzmand","year":"2001"},{"key":"b52-focus16189","series-title":"J Neurosurg","first-page":"455","article-title":"Good outcome in patients with normal-pressure hydrocephalus and factors indicating poor prognosis","volume":"103","author":"Poca","year":"2005"},{"key":"b53-focus16189","series-title":"World Neurosurg","first-page":"555","article-title":"The role of endoscopic third ventriculostomy in the treatment of communicating hydrocephalus","volume":"77","author":"Rangel-Castilla","year":"2012"},{"key":"b54-focus16189","series-title":"Acta Neurochir (Wien)","first-page":"119","article-title":"Clinical experience with a new pressure-adjustable shunt valve","volume":"134","author":"Reinprecht","year":"1995"},{"issue":"3 Suppl","key":"b55-focus16189","series-title":"Neurosurgery","first-page":"S4","article-title":"Diagnosing idiopathic normal-pressure hydrocephalus","volume":"57","author":"Relkin","year":"2005"},{"key":"b56-focus16189","series-title":"Acta Neurochir (Wien)","first-page":"50","article-title":"Reappraisal of the intracranial pressure and cerebrospinal fluid dynamics in patients with the so-called \u201cnormal pressure hydrocephalus\u201d syndrome","volume":"112","author":"Sahuquillo","year":"1991"},{"key":"b57-focus16189","series-title":"J Neurosurg","first-page":"423","article-title":"Adult hydrocephalus. Evaluation of shunt therapy in 80 patients","volume":"37","author":"Salmon","year":"1972"},{"key":"b58-focus16189","series-title":"J Neurol Neurosurg Psychiatry","first-page":"1141","article-title":"Magnetic resonance spectroscopic determination of a neuronal and axonal marker in white matter predicts reversibility of deficits in secondary normal pressure hydrocephalus","volume":"75","author":"Shiino","year":"2004"},{"key":"b59-focus16189","series-title":"Acta Neurochir (Wien)","first-page":"171","article-title":"Change in regional cerebral blood flow following glycerol administration predicts. Clinical result from shunting in normal pressure hydrocephalus","volume":"129","author":"Shimoda","year":"1994"},{"key":"b60-focus16189","series-title":"Arch Neurol","first-page":"34","article-title":"Motor disturbances in normal-pressure hydrocephalus. Special reference to stance and gait","volume":"43","author":"Soelberg S\u00f8rensen","year":"1986"},{"key":"b61-focus16189","series-title":"J Neurosurg","first-page":"463","article-title":"Normal-pressure hydrocephalus. Predicting the results of cerebrospinal fluid shunting","volume":"41","author":"Stein","year":"1974"},{"key":"b62-focus16189","series-title":"J Neurosurg","first-page":"510","article-title":"Cerebral hemodynamics in normal-pressure hydrocephalus. Evaluation by 133Xe inhalation method and dynamic CT study","volume":"61","author":"Tamaki","year":"1984"},{"key":"b63-focus16189","series-title":"Neurosurgery","first-page":"1161","article-title":"Cerebral blood flow and autoregulation in normal pressure hydrocephalus","volume":"40","author":"Tanaka","year":"1997"},{"key":"b64-focus16189","series-title":"J Neurosurg","first-page":"837","article-title":"Noninvasive biomarkers in normal pressure hydrocephalus: evidence for the role of neuroimaging","volume":"110","author":"Tarnaris","year":"2009"},{"key":"b65-focus16189","series-title":"Ann Neurol","first-page":"304","article-title":"Prognosis of dementia in normal-pressure hydrocephalus after a shunt operation","volume":"20","author":"Thomsen","year":"1986"},{"key":"b66-focus16189","series-title":"Br J Neurosurg","first-page":"214","article-title":"Long-term outcome in 109 adult patients operated on for hydrocephalus","volume":"20","author":"Tisell","year":"2006"},{"key":"b67-focus16189","series-title":"J Neurol Neurosurg Psychiatry","first-page":"552","article-title":"Intracranial cerebrospinal fluid measurement studies in suspected idiopathic normal pressure hydrocephalus, secondary normal pressure hydrocephalus, and brain atrophy","volume":"73","author":"Tsunoda","year":"2002"},{"key":"b68-focus16189","series-title":"Acta Neurol Scand","first-page":"322","article-title":"Impaired wakefulness is associated with reduced anterior cingulate CBF in patients with normal pressure hydrocephalus","volume":"110","author":"Tullberg","year":"2004"},{"key":"b69-focus16189","series-title":"Acta Neurol Scand","first-page":"417","article-title":"White matter changes in normal pressure hydrocephalus and Binswanger disease: specificity, predictive value and correlations to axonal degeneration and demyelination","volume":"105","author":"Tullberg","year":"2002"},{"key":"b70-focus16189","series-title":"Neurology","first-page":"54","article-title":"Shunting normal-pressure hydrocephalus: do the benefits outweigh the risks? A multicenter study and literature review","volume":"42","author":"Vanneste","year":"1992"},{"key":"b71-focus16189","series-title":"J Neurol Neurosurg Psychiatry","first-page":"251","article-title":"Shunting normal pressure hydrocephalus: the predictive value of combined clinical and CT data","volume":"56","author":"Vanneste","year":"1993"},{"key":"b72-focus16189","series-title":"J Neurol","first-page":"5","article-title":"Diagnosis and management of normal-pressure hydrocephalus","volume":"247","author":"Vanneste","year":"2000"},{"key":"b73-focus16189","series-title":"J Neurosurg","first-page":"501","article-title":"The syndrome of normal-pressure hydrocephalus","volume":"61","author":"Vassilouthis","year":"1984"},{"key":"b74-focus16189","series-title":"J Neurosurg","first-page":"379","article-title":"Cerebral blood flow in patients with normal-pressure hydrocephalus before and after shunting","volume":"66","author":"Vorstrup","year":"1987"},{"key":"b75-focus16189","series-title":"J Neurol Neurosurg Psychiatry","first-page":"503","article-title":"The value of temporary external lumbar CSF drainage in predicting the outcome of shunting on normal pressure hydrocephalus","volume":"72","author":"Walchenbach","year":"2002"},{"key":"b76-focus16189","series-title":"J Neurol Neurosurg Psychiatry","first-page":"655","article-title":"High resolution SPECT with [99mTc]-d,l-HMPAO in normal pressure hydrocephalus before and after shunt operation","volume":"56","author":"Waldemar","year":"1993"},{"key":"b77-focus16189","series-title":"Chin J Traumatol","first-page":"221","article-title":"Analysis of related factors affecting prognosis of shunt surgery in patients with secondary normal pressure hydrocephalus","volume":"16","author":"Wang","year":"2013"},{"key":"b78-focus16189","series-title":"Brain Inj","first-page":"61","article-title":"Shunt implantation in a special sub-group of post-traumatic hydrocephalus\u2014patients have normal intracranial pressure without clinical representations of hydrocephalus","volume":"23","author":"Wen","year":"2009"},{"key":"b79-focus16189","series-title":"Acta Neurol Scand","first-page":"566","article-title":"Normal pressure hydrocephalus. Predictive value of the cerebrospinal fluid tap-test","volume":"73","author":"Wikkels\u00f6","year":"1986"},{"key":"b80-focus16189","series-title":"Neurology","first-page":"517","article-title":"Normal-pressure hydrocephalus: diagnosis and patient selection for shunt surgery","volume":"24","author":"Wood","year":"1974"},{"key":"b81-focus16189","series-title":"Neuroradiology","first-page":"212","article-title":"Significance of pathognomonic features of normal-pressure hydrocephalus on computerized tomography","volume":"16","author":"Yamada","year":"1978"},{"key":"b82-focus16189","series-title":"J Neurosurg","first-page":"26","article-title":"Experience with a programmable valve shunt system","volume":"91","author":"Yamashita","year":"1999"},{"key":"b83-focus16189","series-title":"Neurosurgery","first-page":"1392","article-title":"Adjustable valves in normal-pressure hydrocephalus: a retrospective study of 218 patients","volume":"51","author":"Zemack","year":"2002"},{"key":"b1-focus16189","series-title":"N Engl J Med","first-page":"117","article-title":"Symptomatic occult hydrocephalus with \u201cnormal\u201d cerebrospinal-fluid pressure. 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