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Practice Guideline: Idiopathic Normal Pressure Hydrocephalus: Response to Shunting and Predictors of Response Neurol 85:2063-2071, Halperin, J.J.,et al, 2015 See this aricle in Pubmed Article Abstract Clinicians may choose to offer shunting for subjective iNPH symptoms and gait (Level C). Because of significant adverse event risk, risks and benefits should be carefully weighed (Level B). Clinicians should inform patients with iNPH with elevated R and their families that they have an increased chance of responding to shunting compared with those without such elevation (Level B). Clinicians may counsel patients with iNPH and their families that (1) positive response to eternal lumbar drainage or to repeated lumbar punctures increases the chance of response to shunting, and (2) increasing age does not decrease the chance of shunting being successful (both Level C).

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