The triad of gait impairment, cognitive decline, and urinary incontinence in the setting of normal CSF pressure has long been described, yet our ability to predict who will experience a prolonged, meaningful response to ventriculoperitoneal (VP) shunting remains limited. 1-4 Unfortunately, the procedure is associated with major risk, and improvements following shunting are not guaranteed and are often short-lived. Assessing the harm to benefit ratio can be problematic. 2,4 It is imperative not only to identify those likely to respond to shunting but also to identify those with a higher risk of adverse events or those unlikely to respond. Here we report a case of right frontal lobe hemorrhage following VP shunt placement in a patient with preoperative MRI evidence of cerebral amyloid angiopathy (CAA).