A 43-year-old patient was recently admitted to the ward who presented with slurred speech, unsteady walking, especially when starting very slowly and hesitantly, having to be assisted in walking, and having severe difficulty urinating. People who have knowledge of Parkinson’s disease may think that these symptoms are very similar to Parkinson’s disease syndrome manifestations. And the patient was also diagnosed with extrapyramidal syndrome by a neurologist from an outside hospital. When he first arrived at our hospital, his primary care physician also treated him for the extrapyramidal syndrome as diagnosed by the internal medicine department, and again there was no significant change in his symptoms. When President Zhang Yuqi checked the room, he carefully inquired about the medical history and the patient’s symptoms and learned that no one else in the patient’s family had such symptoms, and that only 10 months had passed since the onset of such severe symptoms, and that there was no improvement in the effect of taking medications like Medopa. However, his CT film showed enlarged ventricles and significant paraventricular edema, which is a typical image of “normal cranial pressure hydrocephalus”. You may not be familiar with the term “normal cranial pressure hydrocephalus”. In fact, I met such a patient 3 months ago when I went to Baiyin City, Gansu Province for consultation. The patient was an old general, 73 years old, with Parkinson’s disease for more than 6 years, mainly slow movement and unstable walking. The old general’s family wanted to consider DBS surgery and asked me to evaluate him. However, after arriving at the old gentleman’s home, I found that his rigidity symptoms were not very severe and typical, not very consistent with the progression of PD disease, and there was no significant change before or after taking methyldopa. Besides that, the most prominent manifestations were hallucinations and cognitive impairment, repeatedly talking to me mainly about things he could not let go of around the time of his retirement, and not being able to respond fully and correctly when communicating with people. At this point, I had a question mark about his diagnosis, and after looking at his MRI films, I found that there were very obvious signs of ventricular dilation and damage to the white matter of the brain. The patient was considered to have “normal cranial pressure hydrocephalus”, and the director was asked to perform a shunt procedure, and the patient’s symptoms are now significantly improved, especially in terms of cognition. ”Normal cranial pressure hydrocephalus” is not common in clinical practice, and has three main features: cognitive decline, urinary difficulty or incontinence, and motor difficulty mainly gait disorder, all of which are manifestations of neurological treatment, but actually belong to neurosurgical treatment of a disease, which is not very common and not well understood in the past. The disease is not well understood. The treatment of this disease is not complicated, but it is crucial to be able to identify this disease, and many patients are treated as dementia, Parkinson’s syndrome, psychiatric disease, etc. In typical cases, instead of reduced motor function and difficulty walking, the patient shows mainly “starting difficulties” similar to our Parkinson’s disease, as if the feet were pinned to the ground, bending posture, poor postural flexibility, etc., and without significant tremors. The differential diagnosis of geriatric neuropathy is to exclude this disease as well. With the development of medicine, the boundaries between medicine and surgery are no longer so clear-cut, just as the treatment of Parkinson’s disease requires multidisciplinary cooperation, and the diagnosis of Parkinson’s disease also requires joint reference between medicine and surgery, with different perspectives of physicians and surgeons to achieve a more comprehensive, accurate and correct diagnosis and treatment of the disease.