Which imaging features do you use when considering Normal Pressure Hydrocephalus to decide whether to proceed with large-volume LP or lumbar drain trial?

At our center, we follow the approach of the NPH clinic at the Imperial College Hospital in London.

See this excellent review article for further details: Carswell, PMID 36162853.

I personally use the iNPH rad scale based on the prior MDS talks I've attended, but your mileage may vary.