• Victor M Lu, Panagiotis Kerezoudis, Nitesh P Patel, David T Jones, Jeremy K Cutsforth-Gregory, Jonathan Graff-Radford, Neill R Graff-Radford, and Benjamin D Elder.
• Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA. Electronic address: lu.victor@mayo.edu.
• World Neurosurg. 2020 May 1; 137: 429-434.e13.

BackgroundNormal pressure hydrocephalus (NPH) is a syndrome that was characterized several decades ago; however, its optimal diagnosis and management remain unclear. Our objective was to evaluate citation and bibliometric characteristics of the 100 most cited articles about NPH to better understand the state of research efforts in the field and where improvements may arise.MethodsElsevier's Scopus database was searched for the 100 most cited articles that focused on NPH. Articles were characterized and various bibliometric parameters were compared. Categorical data were analyzed using Pearson χ2, and continuous data were analyzed using either linear regression or a Student t test.ResultsThe 100 most cited articles were published between 1965 and 2014, from 16 unique countries in 38 unique journals. The most common outcome types of these articles were clinical (n = 77). Median number of citations and rate of citations were 114 citations and 5.9 citations/year since publication, respectively, with a significant inverse linear relationship between the 2 parameters (P < 0.01). The most common year of publication was 2002 (n = 10), and the most common country of origin was the United States (n = 40). Higher citation rates were associated with more recent articles (P < 0.01) and more authors (P < 0.01).ConclusionsIn the 100 most cited articles about NPH, there has been a distinct shift toward a more globalized effort in recent decades. The lack of more impactful articles in recent decades highlights that particular classic studies still penetrate practice and the possible need to reconsider our contemporary views on NPH to further advance the field.Copyright © 2020 Elsevier Inc. All rights reserved.

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