Intracranial Pressure versus Phase-Contrast MR Imaging for Normal Pressure Hydrocephalus

Wg, Bradley

doi:10.3174/ajnr.a4507

Cited by 10 publications

(8 citation statements)

References 11 publications

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“…NPH is classically defined as a communicating form of hydrocephalus 37 , 73 - 75 without a fully effective non-invasive treatment. 22 , 76 - 80 However, because of the new hydrodynamic concept of hydrocephalus, 81 , 82 as opposed to the classical dichotomy proposed by Dandy, 82 , 83 the use of endoscopic third ventriculostomy (ETV), which is the golden standard for non-communicating cases, 84 has been reported in selected cases of NPH, as an attempt to restore normal intracranial compliance and pulsatility, normalizing the CSF dynamics. 81 , 82 , 85 - 88 The results showed an effectiveness rate of ETV ranging from 21% to 72%.…”

Section: Idiopathic Normal-pressure Hydrocephalus (Inph)mentioning

confidence: 99%

Normal-pressure hydrocephalus: A critical review

Oliveira

Nitrini

Román

2019

Dement. neuropsychol.

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ABSTRACT. Normal-pressure hydrocephalus (NPH) is a potentially reversible syndrome characterized by enlarged cerebral ventricles (ventriculomegaly), cognitive impairment, gait apraxia and urinary incontinence. A critical review of the concept, pathophysiology, diagnosis, and treatment of both idiopathic and secondary NPH was conducted. We searched Medline and PubMed databases from January 2012 to December 2018 using the keywords “normal-pressure hydrocephalus” / “idiopathic normal-pressure hydrocephalus” / “secondary normal-pressure hydrocephalus” / “NPH” / “ventriculoperitoneal shunt”. The initial search produced 341 hits. After careful selection, a total of 54 articles were chosen and additional relevant studies were included during the process of writing this article. NPH is an important cause of potentially reversible dementia, frequent falls and recurrent urinary infections in the elderly. The clinical and imaging features of NPH may be incomplete or nonspecific, posing a diagnostic challenge for medical doctors and often requiring expert assessment to minimize unsuccessful surgical treatments. Recent advances resulting from the use of non-invasive MRI methods for quantifying cerebral blood flow, in particular arterial spin-labeling (ASL), and the frequent association of NPH and obstructive sleep apnea (OSA), offer new avenues to understand and treat NPH.

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Section: Idiopathic Normal-pressure Hydrocephalus (Inph)mentioning

confidence: 99%

Normal-pressure hydrocephalus: A critical review

Oliveira

Nitrini

Román

2019

Dement. neuropsychol.

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“…Bradley et al . in two articles and in a commentary from 2015 emphasise the importance of establishing ACSV values ≥ 2 times higher than values derived from healthy volunteers (age-matched control group) [20,30]. That is why every medical centre performing PC-MRI should have an individual range of values, to correctly select NPH patients who would profit from VPS procedures.…”

Section: Clinical Applicationmentioning

confidence: 99%

Imaging of cerebrospinal fluid flow: fundamentals, techniques, and clinical applications of phase-contrast magnetic resonance imaging

Korbecki¹,

Zimny²,

Podgórski³

et al. 2019

Pol J Radiol

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Cerebrospinal fluid (CSF) is a dynamic compartment of the brain, constantly circulating through the ventricles and subarachnoid space. In recent years knowledge about CSF has expended due to numerous applications of phase-contrast magnetic resonance imaging (PC-MRI) in CSF flow evaluation, leading to the revision of former theories and new concepts about pathophysiology of CSF disorders, which are caused either by alterations in CSF production, absorption, or its hydrodynamics. Although alternative non-invasive techniques have emerged in recent years, PC-MRI is still a fundamental sequence that provides both qualitative and quantitative CSF assessment. PC-MRI is widely used to evaluate CSF hydrodynamics in normal pressure hydrocephalus (NPH), Chiari type I malformations (CMI), syringomyelia, and after neurosurgical procedures. In NPH precisely performed PC-MRI provides reliable clinical information useful for differential diagnosis and selection of patients benefiting from surgical operation. Patients with CMI show abnormalities in CSF dynamics within the subarachnoid space, which are pronounced even further if syringomyelia coexists. Another indication for PC-MRI may be assessment of post-surgical CSF flow normalisation. The aim of this review is to highlight the significance of CSF as a multifunctional entity, to outline both the physical and technical background of PC-MRI, and to state current applications of this technique, not only in the diagnosis of central nervous system disorders, but also in the further clinical monitoring and prognosis after treatment.

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“…However, other recent studies suggest that the aqueductal SV is correlated with the aqueduct area and the ventricular volume but not with the severity or duration of clinical symptoms (Ringstad et al, 2015a ). The significance of the aqueductal SV is therefore still subject to debate (Bradley, 2015 ; Ringstad et al, 2015a , b ).…”

Section: Introductionmentioning

confidence: 99%

Interactions between Flow Oscillations and Biochemical Parameters in the Cerebrospinal Fluid

Puy

Zmudka-Attier

Capel

et al. 2016

Front. Aging Neurosci.

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The equilibrium between the ventricular and lumbar cerebrospinal fluid (CSF) compartments may be disturbed (in terms of flow and biochemistry) in patients with chronic hydrocephalus (CH). Using flow magnetic resonance imaging (MRI) and CSF assays, we sought to determine whether changes in CSF were associated with biochemical alterations. Nine elderly patients with CH underwent phase-contrast MRI. An index of CSF dynamics (Idyn) was defined as the product of the lumbar and ventricular CSF flows. During surgery, samples of CSF were collected from the lumbar and ventricular compartments and assayed for chloride, glucose and total protein. The lumbar/ventricular (L/V) ratio was calculated for each analyte. The ratio between measured and expected levels (Ibioch) was calculated for each analyte and compared with Idyn. Idyn varied from 0 to 100.103μl2.s2. In contrast to the L/V ratios for chloride and glucose, the L/V ratio for total protein varied markedly from one patient to another (mean ± standard deviation (SD): 2.63 ± 1.24). The Ibioch for total protein was strongly correlated with the corresponding Idyn (Spearman’s R: 0.98; p < 5 × 10−5).We observed correlated alterations in CSF flow and biochemical parameters in patients with CH. Our findings also highlight the value of dynamic flow analysis in the interpretation of data on CSF biochemistry.

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Intracranial Pressure versus Phase-Contrast MR Imaging for Normal Pressure Hydrocephalus

Cited by 10 publications

References 11 publications

Normal-pressure hydrocephalus: A critical review

Normal-pressure hydrocephalus: A critical review

Imaging of cerebrospinal fluid flow: fundamentals, techniques, and clinical applications of phase-contrast magnetic resonance imaging

Interactions between Flow Oscillations and Biochemical Parameters in the Cerebrospinal Fluid

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