Guidelines for Management of Idiopathic Normal Pressure Hydrocephalus: Second Edition

TLDR

Idiopathic normal pressure hydrocephalus, a disorder causing dementia, gait disturbance, and urinary incontinence in the elderly, has gained importance as research and high‑level evidence have expanded. The second edition of the Japanese Guidelines was published in July 2011 to provide evidence‑based recommendations on iNPH, and the English version aims to share these ideas internationally and promote research. The Guidelines were revised by a multidisciplinary expert working group of the Japanese Society of Normal Pressure Hydrocephalus together with a Ministry of Health, Labour and Welfare research project on the epidemiology, pathophysiology, and treatment of normal pressure hydrocephalus. Following the first edition, clinical awareness of iNPH rose dramatically and shunt surgeries increased rapidly across Japan.

Abstract

Among the various disorders manifesting dementia, gait disturbance, and urinary incontinence in the elderly population, idiopathic normal pressure hydrocephalus (iNPH) is becoming of great importance. After the publication of the first edition of the Guidelines for Management of Idiopathic Normal Pressure Hydrocephalus in 2004 (the English version was published in 2008), clinical awareness of iNPH has risen dramatically, and the number of shunt surgeries has increased rapidly across Japan. Clinical and basic research on iNPH has increased significantly, and more high-level evidence has since been generated. The second edition of the Japanese Guidelines was thus published in July 2011, to provide a series of timely evidence-based recommendations related to iNPH. The revision of the Guidelines has been undertaken by a multidisciplinary expert working group of the Japanese Society of Normal Pressure Hydrocephalus in conjunction with the Japanese Ministry of Health, Labour and Welfare research project on "Studies on the epidemiology, pathophysiology, and treatment of normal pressure hydrocephalus. This English version of the second edition of the Guidelines was made to share these ideas with the international community and to promote international research on iNPH.