• Ricardo J Komotar, Brad E Zacharia, J Mocco, Michael G Kaiser, Stephen J Frucht, and Guy M McKhann.
• Department of Neurosurgery, Columbia University, New York, New York 10032, USA.
• Neurosurgery. 2008 Oct 1; 63 (4 Suppl 2): 315; discussion 315.

ObjectiveIn this case report, we present a patient with normal pressure hydrocephalus in whom a lumbar drainage trial yielded a false-negative result secondary to cervical spondylosis.Clinical PresentationAn 80-year-old woman presented with classic symptoms of normal pressure hydrocephalus as well as evidence of cervical myelopathy. Magnetic resonance imaging of the brain and spine showed enlarged ventricles and single-level cervical canal narrowing.InterventionAn initial lumbar drainage trial was performed, which revealed negative results. The patient then underwent cervical decompression and fusion. Despite this procedure, the patient's symptoms continued to worsen. A repeat lumbar drainage trial was performed with positive results. Subsequently, a ventriculoperitoneal shunt was placed, resulting in significant improvement of her symptoms.ConclusionThis case report illustrates how altered cerebrospinal fluid flow dynamics may impact the accuracy of the lumbar spinal drainage trial in patients with normal pressure hydrocephalus.

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