Normal pressure hydrocephalus (NPH) is a neurodegenerative disorder that can be treated with a ventricular shunt, improving symptoms. Researchers studied the RNA in extracellular vesicles from 42 NPH patients’ cerebrospinal fluid (CSF) to find genes and pathways linked to symptom improvement after shunt surgery. They developed a machine learning algorithm using these gene profiles to predict surgery response accurately. This discovery could enhance NPH diagnosis, treatment, and understanding of the disease’s causes.