Guidelines for management of idiopathic normal pressure hydrocephalus (Third edition): Endorsed by the Japanese society of normal pressure hydrocephalus

The research committee of idiopathic normal pressure hydrocephalus

Research output: Contribution to journalArticlepeer-review

158 Citations (Scopus)


Among the various disorders that manifest with gait disturbance, cognitive impairment, and urinary incontinence in the elderly population, idiopathic normal pressure hydrocephalus (iNPH) is becoming of great importance. The first edition of these guidelines for management of iNPH was published in 2004, and the second edition in 2012, to provide a series of timely, evidence-based recommendations related to iNPH. Since the last edition, clinical awareness of iNPH has risen dramatically, and clinical and basic research efforts on iNPH have increased significantly. This third edition of the guidelines was made to share these ideas with the international community and to promote international research on iNPH. The revision of the guidelines was undertaken by a multidisciplinary expert working group of the Japanese Society of Normal Pressure Hydro-cephalus in conjunction with the Japanese Ministry of Health, Labour and Welfare research project. This revision proposes a new classification for NPH. The category of iNPH is clearly distinguished from NPH with congenital/developmental and acquired etiologies. Additionally, the essential role of disproportionately enlarged subarachnoid-space hydrocephalus (DESH) in the imaging diagnosis and decision for further management of iNPH is discussed in this edition. We created an algorithm for diagnosis and decision for shunt management. Diagnosis by bio-markers that distinguish prognosis has been also initiated. Therefore, diagnosis and treatment of iNPH have entered a new phase. We hope that this third edition of the guidelines will help patients, their families, and healthcare professionals involved in treating iNPH.

Original languageEnglish
Pages (from-to)63-97
Number of pages35
Journalneurologia medico-chirurgica
Issue number2
Publication statusPublished - 2021


  • Clinical guideline
  • Diagnosis
  • Idiopathic normal pressure hydrocephalus
  • Management
  • Treatment

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology


Dive into the research topics of 'Guidelines for management of idiopathic normal pressure hydrocephalus (Third edition): Endorsed by the Japanese society of normal pressure hydrocephalus'. Together they form a unique fingerprint.

Cite this