Hydrocephalus 2017, the Ninth Annual Meeting of the International Society for Hydrocephalus and CSF disorders (Hydrocephalus Society)

Abstract

Introduction: The cerebrospinal fluid (CSF) circulates through the ventricles and the cranial and spinal subarachnoid spaces that are dynamic compartments. According to MONROE-KELLIE's doctrine, the CSF is distributed constantly in compartments which interact with each other. What happen in the other compartments and the CSF flow when laterals ventricles dilate? Methods: 10 hydrocephalus patients underwent a 3T MRI with morphological and phase contrast sequences to investigate the CSF volume and its flow at the aqueductal (SVaque) and spinal (SVspine) levels. The volume of each CSF compartments lateral ventricles (LV), intracranial spaces (IV) (pontine and cerebellum cisterns) and spinal spaces (SS), were estimated by measuring the CSF area in a selected plane crossing each compartment. CSF areas measurements of each patient were normalized to show the distribution of one CSF compartment in front of another. An Heterogeneity coefficient was calculated based on the standard deviation. Results: In our population LV area presented the high heterogeneity 49%, IV heterogeneity was equal to 27% and heterogeneity for the SS was equal to 41%. Paradoxically increase of the LV compartment seems to induce an increase of the IV spaces and indeterminate change in SS which can increase or decrease a lot. SVaque was positively correlated with LV area (R = 0.63, p = 0.04) whereas SVspine presented no significant correlation with LV area. No significant correlations were measured between CSF flows and the all others areas of CSF. Conclusions: Unlike MONROE-KELLIE's doctrine, the compartments can all increase, so it's the tissue or the venous which should decrease. A2 Excess mortality associated with shunt-dependent hydrocephalus following aneurysmal subarachnoid hemorrhage: a population based study