Zhonghua Yi Xue Za Zhi. 2026 Jul 28;106(27):2795-2818. doi: 10.3760/cma.j.cn112137-20260415-01033.
ABSTRACT
Idiopathic normal pressure hydrocephalus (iNPH) is a common and treatable syndrome related to cerebrospinal fluid circulation disorders in the elderly, with clinical problems including missed diagnosis, misdiagnosis and significant variations in therapeutic efficacy. Therefore, multidisciplinary experts in the Chinese Association for Geriatric Health Care's Hydrocephalus Specialty Branch, the Chinese Medical Association's Neurosurgery Branch, the Chinese Neurosurgery Critical Care Management Collaborative Group, and the Beijing Medical Association's Neurosurgery Branch were organized to formulate the Expert consensus for the diagnosis and treatment of idiopathic normal pressure hydrocephalus (2026 edition). Based on the Chinese expert consensus on the diagnosis and treatment of idiopathic normal pressure hydrocephalu (2016 edition), this consensus systematically reviews relevant literature from January 2016 to June 2025. Combining the findings of comprehensive qualitative analysis and clinical practice, it develops clinical practice recommendations covering epidemiology, pathophysiological mechanisms, diagnosis, assessment, treatment and follow-up. This consensus clarifies the core clinical features, characteristic imaging features, and key auxiliary diagnostic indicators. Comprehensive diagnosis of iNPH requires integration with the results of the cerebrospinal fluid tap test, and differential diagnosis should be made from various neurodegenerative diseases and secondary hydrocephalus. The cerebrospinal fluid tap test is recommended as the core preoperative evaluation tool, with standardized multi-dimensional assessment methods for cognition, urinary function and gaitto match the test. Surgical shunting is confirmed as the current effective treatment, with detailed recommendations on the selection of surgical approaches, shunt system selection and the management of comorbidities, 39 recommendations were finally established. This consensus provides a standardized reference for the clinical diagnosis, assessment and treatment of iNPH. It also highlights future research directions, including early diagnostic biomarkers, minimally invasive surgical techniques and intelligent shunt systems.
PMID:42503918 | DOI:10.3760/cma.j.cn112137-20260415-01033