Objective.The aim of this study was to analyze the outcome of shunting in critical patients who had normal pressure hydrocephalus (NPH) after severe aneurysmal sub arachnoid hemorrhage (aSAH) and to determine the potential predictors for shunting.Methods.Patients diagnosed with NPH due to severe aSAH (Ⅲ, Ⅳ, Ⅴ Hunt-Hess grades) from July 2008 to April 2012 were enrolled.Information regarding patients demography, clinical manifestation, and neuroimaging findings was systematically es tablished.The Mini Mental Scale Examination (MMSE) and Barthel Index (BI) were used for 3month and lyear follow-up rehabilitation measures.Results.Of the total 28 patients, remarkable improvement at the 3 month and 1 year follow-ups were observed (P <.05) after shunt implantation in 18 patients (64.3%) who were younger (P--.022), had better neurological function (higher Glasgow Coma Score, P <.001), and less severity of hydrocephalus (lower EI, P =.011) compared to those who remained unimproved.Additionally, the MMSE (P =.043) and BI (P =.008) scores were significantly raised at the 1 year follow-up, but no change was found at the 3 month follow-up (P>0.05).Conclusions.In our study, critical patients who had NPH due to severe aSAH would benefit from shunt placement when given the correct candidates and timely manage ment of shunt malfunction.Additionally, the curative effect of shunt insertion should have been regarded as a long-term goal of rehabilitation in these patients.