The Pathophysiology of Idiopathic Normal Pressure Hydrocephalus: Cerebral Ischemia or Altered Venous Hemodynamics?

Bateman, Grant A.

doi:10.3174/ajnr.a0739

Cited by 158 publications

(126 citation statements)

References 41 publications

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“…⌬V ART and ⌬V SC can be measured with PC-MR imaging. 10,12 Moreover, the difference between the arterial volume increase and the volume shifted to the spinal compartment is the ⌬V IC . It follows that PC-MR imaging and lumbar CSF infusion measurements can be combined to calculate PVI CC , PVI IC , and PVI SC .…”

Section: Methodsmentioning

confidence: 99%

Assessment of Craniospinal Pressure-Volume Indices

Wåhlin¹,

Ambarki²,

Birgander³

et al. 2010

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:The PVI CC of the craniospinal compartment defines the shape of the pressure-volume curve and determines the damping of cyclic arterial pulsations. Despite no reports of direct measurements of the PVI CC among healthy elderly, it is believed that a change away from adequate accommodation of cardiac-related pulsations may be a pathophysiologic mechanism seen in neurodegenerative disorders such as Alzheimer disease and idiopathic normal pressure hydrocephalus. In this study, blood and CSF flow measurements are combined with lumbar CSF infusion measurements to assess the craniospinal PVI CC and its distribution of cranial and spinal compartments in healthy elderly.

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Section: Methodsmentioning

confidence: 99%

Assessment of Craniospinal Pressure-Volume Indices

Wåhlin¹,

Ambarki²,

Birgander³

et al. 2010

AJNR Am J Neuroradiol

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show abstract

“…9) On the other hand, an overlap in the CBF volumes measured between patients with NPH and normal subjects suggested that ischemia may not be a prerequisite for this condition, but instead may reflect increased superficial venous pressure in patients with NPH. 1) Cerebral circulatory disorders in patients with NPH can manifest as either of two pathophysiological conditions: circulatory disorder of the cerebral cortical region, and that of the thalamus-basal ganglia region, and various patterns may develop according to the disease stage. 15) Such discrepant explanations may derive from the absence of comprehensive understanding of NPH, which is actually a dynamic and divergent disease in Neurol Med Chir (Tokyo) 48, October, 2008 S. Tsutsumi et al…”

Section: Discussionmentioning

confidence: 99%

Basilar Apex Aneurysm Manifesting as Third Ventricular Mass and Obstructive Hydrocephalus -Case Report-

Tsutsumi

Kondo

Abe

et al. 2008

Neurol. Med. Chir.(Tokyo)

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A 58-year-old male, with a past history of hypertensive thalamic hemorrhage 12 years before, presented with gradually exaggerating gait disturbance, memory disturbance, and urinary incontinence. On admission, he had gait disturbance represented by petit pas and anteropulsion in addition to significant recent memory disturbance. Cranial computed tomography (CT) revealed a hyperdense mass in the third ventricle with triventricular dilation. Cerebral magnetic resonance (MR) imaging and MR angiography identified the third ventricular lesion as saccular basilar apex aneurysm. No other intracranial abnormal intensity contributing to his clinical symptoms was recognized. Cervical MR angiography showed normal findings. Cerebral blood flow (CBF) measurements revealed diffuse CBF reduction in the cerebral hemisphere. The patient underwent coil embolization which accomplished complete aneurysm occlusion. He showed only slight improvement in his gait disturbance after embolization, and CT following embolization revealed persistent ventriculomegaly. Ventriculoperitoneal shunting was carried out. Intraoperative neuroendoscopy demonstrated cerebrospinal fluid (CSF) obstruction caused by the embolized aneurysm at the level of the third ventricle, with normal CSF findings. Postoperatively his gait disturbance and intellectual impairment showed remarkable improvement. Basilar apex aneurysm associated with obstructive hydrocephalus has complex underlying pathology and should be treated by a combination of definitive aneurysm obliteration and CSF diversion.

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“…Sowohl die intrakraniellen Binnenbewegungen des Liquors als auch die Nettovolumenschwankungen der drei Kompartimente Parenchym, Blut und Zerebrospinalflüssig-keit waren nun einer Auflösung innerhalb einer einzelnen Herzaktion zugänglich. Wegweisende Messungen führten Greitz [12] und Bateman [13][14][15][16][17] durch und entwickelten ein Verständnis der Pathophysiologie des Normaldruckhydrozephalus, dessen pathogenetischen Ausgangspunkt eine herabgesetzte Compliance der zerebralen Blutgefässe bildet. Die physiologische Blutversorgung des Gehirns beginnt mit einem pulswellenartigen Blutstrom im Bereich der grossen Hirnbasisarterien und der subarachnoidal verlaufenden Arterien.…”

Section: Pulswellen Und Magnetresonanztomografieunclassified

“…Daraus folgt eine minimale systolische Volumenzunahme des Hirnparenchyms unter physiologischen Bedingungen. Dies äussert sich in der minimalen systolischen Liquorauslagerung über das Aquädukt, die unter physiologischen Bedingungen nur 30 µl beträgt [12,16].…”

Section: Pulswellen Und Magnetresonanztomografieunclassified

Zur Pathophysiologie des Normaldruckhydrozephalus

2010

Swiss Arch Neurol Psychiatr

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The Pathophysiology of Idiopathic Normal Pressure Hydrocephalus: Cerebral Ischemia or Altered Venous Hemodynamics?

Cited by 158 publications

References 41 publications

Assessment of Craniospinal Pressure-Volume Indices

Assessment of Craniospinal Pressure-Volume Indices

Basilar Apex Aneurysm Manifesting as Third Ventricular Mass and Obstructive Hydrocephalus -Case Report-

Zur Pathophysiologie des Normaldruckhydrozephalus

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