Normal pressure hydrocephalus

Hakim and Adams criteria[26]Hakim S, Adams RD. The special clinical problem of symptomatic hydrocephalus with normal cerebrospinal fluid pressure. Observations on cerebrospinal fluid hydrodynamics. J Neurol Sci. 1965 Jul-Aug;2(4):307-27. http://www.ncbi.nlm.nih.gov/pubmed/5889177?tool=bestpractice.com

There are no widely accepted criteria for the diagnosis or grading of NPH. The triad of "mild impairment of memory and slowness of thought and action, unsteadiness of gait, and unwitting urinary incontinence" was described in 1965, and these remain the standard diagnostic criteria, but the condition should be considered in any patient with levodopa-unresponsive gait apraxia, whether or not urinary or cognitive symptoms are present. Walking speed is generally a good reflection of the severity of the condition.