Normal pressure hydrocephalus, is not uncommon in clinical practice, and some patients are chronically unaware of what specialty they are being seen in, delaying treatment. Normal pressure hydrocephalus is a disease that occurs in middle-aged and elderly people. Patients have symptoms of hydrocephalus, but a lumbar puncture shows normal or near-normal cerebrospinal fluid pressure. The typical manifestations of the disease are the triad of gait abnormalities, dementia, and urinary incontinence. Gait abnormalities refer to the difficulty in starting as if the foot is stuck to the floor (hence the name magnetic gait); difficulty in turning or going around obstacles, requiring more steps. Patients have subcortical mental impairment, including inattention, amnesia, and slowness to receive information; however, there is no aphasia, dysfunction, or loss of recognition. Urinary incontinence or other voiding disorders generally do not occur until the disease is more advanced, and fecal incontinence is rare. The etiology of normal pressure hydrocephalus is unknown in about half of the patients and is therefore referred to as idiopathic normal pressure hydrocephalus. The remaining causes are subarachnoid hemorrhage, meningitis, cranial trauma, or surgery. The mechanism of occurrence is the enlargement of the ventricles in the early stage of hydrocephalus formation due to the increase of intracranial pressure. When the ventricular enlargement reaches a certain level, the pressure gradually decreases and a new equilibrium between the enlarged ventricle and the intracranial pressure is re-established, and a compensatory state occurs. When the intracranial pressure drops to the normal range, the ventricles remain enlarged, resulting in normal pressure hydrocephalus. The enlarged anterior horn of the ventricle pulls on the sacral motor nerve fibers, affecting the innervation of the lower extremities and sphincter muscles, leading to gait abnormalities and urinary incontinence; the enlarged periventricular arteries and veins are stretched and squeezed, affecting the microcirculation around the limbic system and leading to impaired cognitive function. There is no effective pharmacological treatment for normal pressure hydrocephalus. Surgical shunting of cerebrospinal fluid (e.g., ventriculo-abdominal shunt) is the best proven treatment, but it is only effective in some patients, resulting in substantial improvement in 30% to 50% of patients with idiopathic as well as 50% to 70% of patients with secondary normal pressure hydrocephalus. It is generally more effective in young patients than in older patients and is more effective in patients with symptoms that have been present for shorter than 6 months.