Analysis of aqueductal cerebrospinal fluid flow after endoscopic aqueductoplasty by using cine phase-contrast magnetic resonance imaging

Schroeder, Henry W. S.; Schweim, Christiane; Schweim, Klaus H.; Gaab, M. R.

doi:10.3171/foc.2000.9.2.7

Cited by 14 publications

(17 citation statements)

References 61 publications

(78 reference statements)

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“…Many authors have demonstrated the value of cardiac-gated measurement of CSF flow, especially in the aqueductal structures [11,12,13,20,21,22,23]. Moreover, some authors have assessed infratentorial brain motion in response to systolic contraction of the heart, also with an ECG-gated technique [24,25]; however, these techniques are much more time-consuming and difficult to perform.…”

Section: Discussionmentioning

confidence: 98%

Demonstration of periventricular brain motion during a Valsalva maneuver: description of technique, evaluation in healthy volunteers and first results in hydrocephalic patients

Ertl‐Wagner¹,

Lienemann²,

Reith

et al. 2001

Eur Radiol

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There has long been a need for a sensitive and predictive parameter in the evaluation of hydrocephalic patients. Our goal was to assess ventricular response to a Valsalva maneuver as a potential method of studying patients with hydrocephalus. Twenty-five healthy volunteers and 5 patients with communicating hydrocephalus were examined with an axial and 10 volunteers with an axial, coronal and sagittal true fast imaging steady precession (FISP) sequence in a 1.5-T clinical MR scanner (TR 4.8 ms, TE 2.3 ms, flip angle 70 degrees, slice thickness 5 mm, field of view 330 mm, 3 slices). Images were assessed both as dynamic images in cine mode and by measuring lateral ventricular size over time. All volunteers showed marked periventricular brain motion. The lateral ventricular area was reduced under the Valsalva maneuver by an average of 18% (SD 7) in healthy volunteers, while remaining practically constant in the patient group. Differences were statistically significant with a p<0.0001. The Valsalva maneuver leads to periventricular brain motion, which can be consistently detected by a true FISP sequence. Our method proved to be an easy and reliable method with a capacity to identify hydrocephalic patients.

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Section: Discussionmentioning

confidence: 98%

Demonstration of periventricular brain motion during a Valsalva maneuver: description of technique, evaluation in healthy volunteers and first results in hydrocephalic patients

Ertl‐Wagner¹,

Lienemann²,

Reith

et al. 2001

Eur Radiol

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show abstract

“…Moreover, the conventional MRI imaging can provide direct or indirect signs suggesting aqueduct obstruction, these signs are hardly validated and seem to be difficult to use especially in postoperative outcome evaluation [18]. Many reports suggested the complementary use of the rapid, easy and non-invasive cine phase contrast MR imaging sequences to prove the obstruction of the CSF circulation at the aqueductal level [1,16].…”

Section: Discussionmentioning

confidence: 99%

Endoscopic third ventriculostomy for post-inflammatory hydrocephalus in pediatric patients: is it worth a try?

2014

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Hydrocephalus is a very common disease in developing countries. Congenital aqueductal obstruction and post-inflammatory hydrocephalus come on the top of the list of causes of hydrocephalus. Till the recent introduction of cranial endoscopy and despite their frequent complications, shunts were considered as the mainstream treatment for this disease. Endoscopic third ventriculostomy (ETV), especially for obstructive hydrocephalus, introduced a new era of treatment that is free of lifetime shunt dependency. This study was done to assess the efficacy of ETV for treating post-inflammatory hydrocephalus in a unique group of patients thus preventing—if possible—the lifetime shunt dependency and suffering. ETV was tried as a first-line therapy in 35 children (23 males and 12 females) with hydrocephalus proved to be secondary to intracranial infection. Mean age was 9.2 months (4-15). Twenty-four patients (68.6%) were below the age of 6 months while 11 patients (31.4%) were above 6 months. Twenty-five patients (71.4%) had a head circumference of 3 cm and 10 patients (28.6%) had a 5 cm or more increase in the head circumference above the 95th percentile. All the patients included were followed postoperatively with regular clinical, computerized tomography (CT), and magnetic resonance imaging (MRI) examinations as well as cerebrospinal fluid (CSF) analysis and culture. The overall success of ETV was 55.9% (19/34). Nine (81.9%) out of the 11 patients that were endoscopically documented to have aqueductal obstruction showed improvement. While out of the 23 patients with patent aqueduct, only 10 patients (43.4%) had improved. Procedure-related complications were not encountered. CSF leakage from the surgical wound occurred in three patients and mild CSF infection occurred in one patient. ETV is a simple, safe, and effective method in treating not only obstructive hydrocephalus due to non-inflammatory etiology, but also post-inflammatory hydrocephalus especially when the aqueduct is obstructed. An overall 50% improvement in our study and even more in other series encourage the trial of getting rid of the lifetime shunt complications and suffering.

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“…Computed tomography and neurological tests are additional diagnostic methods that may be used for the identification of CM-I [16]. Another common examination method is the use of a phasecontrast (PC) cine MRI that allows the assessment of CSF flow and velocity [6,17,18]. Treatment of CM-I is achieved by a surgical operation called posterior fossa decompression [19].…”

Section: Introductionmentioning

confidence: 99%

Fractal dimension analysis of cerebellum in Chiari Malformation type I

Akar¹,

Kara²,

Akdemir³

et al. 2015

Computers in Biology and Medicine

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Analysis of aqueductal cerebrospinal fluid flow after endoscopic aqueductoplasty by using cine phase-contrast magnetic resonance imaging

Cited by 14 publications

References 61 publications

Demonstration of periventricular brain motion during a Valsalva maneuver: description of technique, evaluation in healthy volunteers and first results in hydrocephalic patients

Demonstration of periventricular brain motion during a Valsalva maneuver: description of technique, evaluation in healthy volunteers and first results in hydrocephalic patients

Endoscopic third ventriculostomy for post-inflammatory hydrocephalus in pediatric patients: is it worth a try?

Fractal dimension analysis of cerebellum in Chiari Malformation type I

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