Patient: Hello! My father is 62 years old. Recently, he has been losing things and forgetting everything he says; he can’t remember where he is when he goes out. Sometimes he can’t walk steadily, his feet seem to be sucked by a magnet, he can’t turn around, and when he has to urinate, he can’t even go to the toilet in time. When I went to a nearby hospital, the doctor said that it might be hydrocephalus, so my family is very anxious. What is hydrocephalus? Is it the water in the brain that everyone talks about? Is there any good solution? Dr. Zheng Yan, Neurosurgery Department, Shanghai Renji Hospital: Hello! The situation you mentioned in your letter belongs to the typical symptoms of normal pressure hydrocephalus, which we call “hydrocephalus triad”. The main symptoms include: cognitive dysfunction, walking and motor dysfunction, and urinary incontinence. Our brain is originally immersed in water, which is a buffer to prevent brain damage during exercise, but when there is more water in the skull, it compresses the brain tissue and causes problems. Normal pressure hydrocephalus is a group of hydrocephalus syndromes with an enlarged ventricle of unknown etiology but relatively normal cerebrospinal fluid pressure. The most effective treatment is currently cerebrospinal fluid shunt surgery. As China enters an aging society, the incidence of normal pressure hydrocephalus is on the rise. However, it is important to note that patients with normal pressure hydrocephalus often need to be differentiated from the following three conditions: 1. Patients with normal pressure hydrocephalus have intellectual disability, but to a lesser degree than patients with Alzheimer’s disease. Patients with senile dementia often have no motor impairment and walk as usual; 2. Patients with normal pressure hydrocephalus have difficulty walking, such as duck walk, broad point gait. It looks like Parkinson’s disease, but patients with Parkinson’s disease have a small gait and no intellectual impairment; 3. Most patients with normal pressure hydrocephalus are elderly, and the presence of urinary incontinence also requires identification of the urinary system. Our neurosurgeon, not only combined with our neurologist and radiologist, but also combined with foreign norms of normal pressure hydrocephalus treatment, and worked out a medical routine that meets the characteristics of Chinese people. Special indicators were established to assess the intelligence, walking and urinary functions of patients with normal pressure hydrocephalus, and the efficacy of shunt surgery for normal pressure hydrocephalus was predicted through auxiliary examinations, which improved the efficiency of minimally invasive surgery. By screening through symptom assessment, the effective rate of shunt surgery increased from 61% to 73%; by screening through the auxiliary test of lumbar puncture fluid release test, the effective rate of their shunt surgery could be increased to more than 90%. The standardized assessment and treatment did allow some patients with normal pressure hydrocephalus to significantly improve their ambulation, speech manipulation and memory, which improved their quality of life and greatly reduced the care workload of their families. In conclusion, normal pressure hydrocephalus is a chronic disease that significantly reduces the quality of life of patients and brings a serious burden of life to families.