Originally Posted by j1aims
pt. has NPH symptoms, asked what is the next step. Do you need to get imaging before doing LP?
Yep. First exclude the usual causes of hydrocephalus with MRI (in patient with NPH there would be ventriculomegaly without evidence of CSF obstruction) followed by invasive tests (LP, lumbar tap test where removal of small amount of CSF is associated with subjective improvement of gait for a short period of time, ICP monitoring, etc).