Normal pressure hydrocephalus (NPH): CSF drainage tests

Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .

Normal pressure hydrocephalus (NPH): CSF drainage tests. Spinal tap test: removal of 30-70ml. Fully referenced neurology checklist.

Types of CSF drainage tests

  • Spinal tap test: removal of 30-70ml
  • Continuous drainage: removal of 150-200ml daily for 2-7 days

Indicators of positive CSF drainage tests

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Precautions in interpreting CSF drainage tests

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References

  1. Kiefer M, Unterberg A. The differential diagnosis and treatment of normal-pressure hydrocephalus. Dtsch Arztebl Int 2012; 109:15-26.
  2. Kahlon B, Sundbärg G, Rehncrona S. Comparison between the lumbar infusion and CSF tap tests to predict outcome after shunt surgery in suspected normal pressure hydrocephalus. JNNP 2002; 73:721-726.
  3. Ertl M, Aigner R, Krost M, et al. Measuring changes in the optic nerve sheath diameter in patients with idiopathic normal-pressure hydrocephalus: a useful diagnostic supplement to spinal tap tests. Eur J Neurol 2017; 24:461-467.
  4. Yoshida A, Miyaue N, Ito Y, Yabe H. Association between periventricular white matter hyperintensities around the anterior horn and CSF tap test responsiveness in idiopathic normal pressure hydrocephalus. J Neurol Sci 2026; 486:125908.
  5. Yamada S, Ishikawa M, Miyajima M, et al; SINPHONI-2 Investigators (Appendix). Disease duration: the key to accurate CSF tap test in iNPH. Acta Neurol Scand 2017; 135:189-196.
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