Normal pressure hydrocephalus in the elderly: a treatable cause of dementia?

Although normal pressure hydrocephalus is one of the few remediable causes of dementia, the diagnosis is often not considered in the elderly. Three patients are described who presented to an acute geriatric unit within a six-month period during which normal pressure hydrocephalus was actively sought and treated. Although two made striking initial improvement, the long-term prognosis was poor: complications were frequent, and all three died within two years of operation. This pilot study indicates that normal pressure hydrocephalus may account for a proportion of cases of 'senile' dementia, but that formal controlled studies are required to establish the best means of diagnosis and treatment.