Objective:

To report on the safety and outcomes of combined shunt surgery and lecanemab therapy in patients with idiopathic normal pressure hydrocephalus (iNPH) and Alzheimer's disease (AD), highlighting the significance of this combined approach in clinical practice.

Key Findings:

• Both patients had comorbid iNPH and AD, with varying treatment sequences.
• Case 1 showed significant cognitive improvement post-LP shunt surgery without adverse events.
• Case 2's VP shunt surgery was performed without complications, but specific cognitive outcomes should be included.

Interpretation:

The combination of shunt surgery and lecanemab therapy appears feasible, with no immediate adverse effects observed in the reported cases, suggesting potential implications for clinical practice.

Limitations:

• Only two cases are reported, limiting generalizability.
• Long-term outcomes and potential risks of combined therapy remain unclear, particularly due to the lack of follow-up data.

Conclusion:

Combined treatment of shunt surgery and lecanemab therapy may be safe for patients with iNPH and AD, warranting further investigation in larger cohorts, particularly focusing on long-term outcomes and safety.