Earlier studies show that a good shunt response is also seen in iNPH patients with extensive presumed ischemic white matter lesions [16, 29], that radiological signs of cerebrovascular disease cannot predict the outcome in iNPH patients , and that the magnitude of improvement in patients with and without vascular comorbidities is the same . However, other studies report contrasting findings, showing less improvement in patients with signs of ischemic cerebrovascular disease [31, 32]. There is little information regarding the effects of vascular risk factors and comorbidities on the long-term outcome in iNPH patients [16, 33].