Patient with clinical symptoms of gait disturbance and memory impairment was originally diagnosed with Parkinson disease. Treatment for Parkinson disease did not improve his symptoms hence he was referred to neurosurgery for a consult. After evaluation of the patient, possible diagnosis of iNPH was made which led to the enrollment of the patient in external lumbar drain trial. External Lumbar Drain Trial: The external lumbar drain was placed on first day of admission following the assessment and recording of baseline gait. Setting of the drain was set at 10ml per hour. Evaluation of the gait was recorded on second, third and fourth day of admission. In addition. patient was being examined by occupational therapy and physical therapy for mental status changes as well as gait improvement. His overall behavior was observed by his family and nursing staff and all changes were recorded. Two weeks post lumbar drain trial, patient was seen at clinic for further evaluation. At that time, patient was examined for gait, cognitive abilities, and behavior. Based on the result of the trial as well as patient's family and nursing input and the review of the videos, a decision was made. If obvious gait and cognitive improvement was observed in the patient, surgery for shunt placement was offered. In this case surgery was indicated and led to a significant improvement in patient's quality of life.