Nationwide Incidence of Normal Pressure Hydrocephalus (NPH) Assessed by Insurance Claim Data in Germany

Johannes Lemcke1, *, Dirk Stengel2, 3, Florian Stockhammer4, Claas Güthoff2, Veit Rohde4, Ullrich Meier1
1 Department of Neurosurgery, Unfallkrankenhaus Berlin, Germany
2 Center for Clinical Research, Department of Trauma and Orthopedic Surgery, Unfallkrankenhaus Berlin, Germany
3 Julius Wolff Institute, Charité Medical University Center, Berlin, Germany
4 Department of Neurosurgery, Georg August University of Göttingen, Germany

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Creative Commons License
© Lemcke et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution-Non-Commercial 4.0 International Public License (CC BY-NC 4.0) (, which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.

* Address correspondence to this author at the Department of Neurosurgery, Unfallkrankenhaus Berlin, Warener Str. 7, 12683 Berlin, Germany; Tel: ++49 30 5681 37016; Fax: ++49 30 5681 3703; E-mails:,



The purpose of this study is to investigate the epidemiology of the idiopathic normal pressure hydrocephalus (iNPH) in Germany.


The database of the nationwide Barmer Health Insurance was queried for specific combinations of corresponding International Classification of Diseases, Ninth Revision (ICD-9) codes and OPS codes (German modification of the ICPM and official classification of surgical procedures) in order to assess the number of patients treated for iNPH and the number surgical procedures associated with the disease in a 10 years period between 2003 and 2012.


Between 2003 and 2012, the incidence of iNPH increased from zero to 1.36/100.000/year.


This is the first population-based epidemiologic study on iNPH in Germany covering a ten year period.

Keywords: Epidemiology, Incidence, Normal pressure hydrocephalus, Shunt surgery.