Current practice patterns among Indian neurologists in the Evaluation and management of Normal Pressure Hydrocephalus: A nationwide cross‐sectional survey

INTRODUCTION: This cross-sectional study explores the diagnostic and management practices of normal pressure hydrocephalus (NPH) in India. METHODS: A 16-question online survey based on the Checklist for Reporting Results of Internet E-Surveys checklist was disseminated via closed social media and academic groups. RESULTS: A total of 59 neurologists responded. There was significant variability in how the cerebrospinal fluid (CSF) tap test (TT) was implemented. Although 95% of practitioners performed a CSF TT before referring patients for surgery, there were differences in the volume of CSF removed, the assessment tools used, thresholds, and the timing of post-test evaluations. Notably, 36% of neurologists relied on subjective assessment instead of objective scoring to determine CSF TT responsiveness. One-third still considered surgical referral even if the CSF TT was negative, especially when imaging was strongly suggestive of the diagnosis. CONCLUSION: This study highlights considerable heterogeneity in the evaluation of NPH in India. We need evidence-based practice parameters to ensure accurate diagnosis, informed treatment decisions, and improved patient outcomes.