{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T02:29:20Z","timestamp":1789439360380,"version":"build-2803163510"},"reference-count":35,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T00:00:00Z","timestamp":1698624000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tomography"],"abstract":"<jats:p>Normal Pressure Hydrocephalus (iNPH) typically affects the elderly and can cause cognitive decline, resulting in its differential diagnosis with other neurodegenerative conditions. Moreover, it is probably underdiagnosed; such under- and misdiagnosis prevents the patient from receiving the right treatment and significantly affects the quality of life and life expectancy. This investigation is an in-depth analysis of the actual incidence of iNPH in the population of the province served by our hospital (circa 580,000 individuals). The first phase of this study was conducted by visualizing a total of 1232 brain CT scans performed in the Emergency Departments of the four hospitals of our network on patients who were admitted for different complaints yet screened as suspicious for iNPH. Subsequently, corresponding Emergency Department medical records were investigated to understand the medical history of each patient in search of elements attributable to an alteration of CSF dynamics. The cohort of positive CT scans, according to the radiological and clinical inclusion criteria, included 192 patients. Among the reasons to require acute medical care, \u201cFall\u201d was the most common. The cumulative incidence of CT scans suggestive of iNPH among the patients undergoing CT scans was as high as 15.58%, and the period prevalence calculated for the total amount of patients accessing the Emergency Departments was 1.084%. The real incidence of iNPH in the population may be underestimated, and the social burden linked to the assistance of patients suffering from such untreated conditions could be significantly relieved.<\/jats:p>","DOI":"10.3390\/tomography9060157","type":"journal-article","created":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T13:26:55Z","timestamp":1698672415000},"page":"2006-2015","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Idiopathic Normal Pressure Hydrocephalus: The Real Social and Economic Burden of a Possibly Enormous Underdiagnosis Problem"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9351-2501","authenticated-orcid":false,"given":"Gianpaolo","family":"Petrella","sequence":"first","affiliation":[{"name":"Neurosurgery Division, A.O. \u201cSanta Maria Goretti\u201d General Hospital, Via Guido Reni 1, 04100 Latina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3807-0410","authenticated-orcid":false,"given":"Silvia","family":"Ciarlo","sequence":"additional","affiliation":[{"name":"Neurosurgery Division, A.O. \u201cSanta Maria Goretti\u201d General Hospital, Via Guido Reni 1, 04100 Latina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Elia","sequence":"additional","affiliation":[{"name":"Neurosurgery Division, A.O. \u201cSanta Maria Goretti\u201d General Hospital, Via Guido Reni 1, 04100 Latina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita Dal","family":"Piaz","sequence":"additional","affiliation":[{"name":"Emergency Department, A.O. \u201cSanta Maria Goretti\u201d General Hospital, Via Guido Reni 1, 04100 Latina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Nucera","sequence":"additional","affiliation":[{"name":"Emergency Department, A.O. \u201cDono Svizzero\u201d General Hospital, Via Appia Lato Napoli, 04023 Formia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"Pompucci","sequence":"additional","affiliation":[{"name":"Neurosurgery Division, A.O. \u201cSanta Maria Goretti\u201d General Hospital, Via Guido Reni 1, 04100 Latina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5131-1392","authenticated-orcid":false,"given":"Mauro","family":"Palmieri","sequence":"additional","affiliation":[{"name":"Department of Human Neurosciences, Neurosurgery Division, Universit\u00e0 \u201cLa Sapienza\u201d di Roma, Viale del Policlinico 155, 00161 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Pesce","sequence":"additional","affiliation":[{"name":"Neurosurgery Division, A.O. \u201cSanta Maria Goretti\u201d General Hospital, Via Guido Reni 1, 04100 Latina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/0022-510X(65)90016-X","article-title":"The special clinical problem of symptomatic hydrocephalus with normal cerebrospinal fluid pressure. 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