ReviewCureus2026
Efficacy and Safety of CSF Shunting for Idiopathic Normal Pressure Hydrocephalus: A Systematic Review and Meta-Analysis.
Review in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Idiopathic normal pressure hydrocephalus (iNPH) is a potentially reversible neurological condition characterized by gait disturbance, cognitive impairment, and urinary dysfunction. CSF shunting remains the standard treatment; however, reported efficacy and complication rates vary across studies. This systematic review and meta-analysis aimed to evaluate the effectiveness and safety of CSF shunting in patients with iNPH based exclusively on evidence from randomized controlled trials (RCTs). The review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Literature searches were performed in PubMed, ScienceDirect, and the Cochrane Library for English-language RCTs published since 2010. Eligible studies included patients aged ≥60 years with radiologically confirmed iNPH who underwent ventriculoperitoneal or lumboperitoneal shunting. Primary outcomes included changes in modified Rankin Scale (mRS) scores and gait velocity. Secondary outcomes included cognitive and urinary measures, as well as adverse events. Random-effects models were applied. Three RCTs comprising 210 participants were included. CSF shunting was associated with significant improvement in functional outcomes (MD, -0.75; 95% CI, -1.01 to -0.49) and gait velocity (MD, 0.21 m/s; 95% CI, 0.12 to 0.29), with low heterogeneity. No significant improvement was observed in cognitive or urinary outcomes. However, shunting was associated with an increased risk of subdural hematoma. CSF shunting provides meaningful functional and gait benefits in carefully selected patients with iNPH, although it is associated with an elevated risk of subdural hematoma. Careful patient selection and risk-benefit evaluation remain essential.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.