Agreement Between CSF Flow Dynamics in MRI and ICP Monitoring in the Diagnosis of Normal Pressure Hydrocephalus. Sensitivity and Specificity of CSF Dynamics to Predict Outcome

2002 ◽  
pp. 7-10
Author(s):  
M. A. Poca ◽  
J. Sahuquillo ◽  
M. Busto ◽  
A. Rovira ◽  
J. Capellades ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Normal Pressure Hydrocephalus ◽  
Normal Pressure ◽  
Flow Dynamics ◽  
Icp Monitoring ◽  
Csf Flow ◽  
Csf Dynamics

Progressive ventricular dilatation following pneumoencephalography

1972 ◽  
Vol 36 (1) ◽  
pp. 50-59 ◽  
Author(s):  
Richard L. Rovit ◽  
Mannie M. Schechter ◽  
Benbienizi Ortega ◽  
Ray A. Brinker
Keyword(s):  
Normal Pressure Hydrocephalus ◽  
Clinical Evidence ◽  
Normal Pressure ◽  
Ventricular Dilatation ◽  
Additional Parameter ◽  
Contrast Study ◽  
Csf Flow ◽  
Content Type ◽  
Radiological Studies ◽  
Basal Cisterns

✓ Eight patients with “normal pressure hydrocephalus” are presented who demonstrated radiographic and occasional clinical evidence of progressive dilatation of the ventricles following pneumoencephalography. The characteristic pneumographic signs of tentorial obstruction to the flow of cerebrospinal fluid (CSF) had been documented in the original air contrast study. The authors postulate that pneumoencephalography in patients with normal pressure hydrocephalus may result in a sudden displacement of CSF from the ventricles into the already compromised basal cisterns, leading to further obstruction of CSF outflow and progressive ventricular dilatation. Other mechanisms such as reduction in the potential resorptive capacity of the ventricular ependyma by air replacing ventricular fluid may play a part. The value of repeat radiological studies 24 and 48 hours after the original pneumogram is emphasized both as an aid in the radiological diagnosis of normal pressure hydrocephalus and as an additional parameter for studying problems in CSF flow and absorption.

Cine-MR Imaging of Aqueductal CSF Flow in Normal Pressure Hydrocephalus Syndrome before and after CSF Shunt

1993 ◽  
Vol 34 (6) ◽  
pp. 586-592 ◽  
Author(s):  
M. Mascalchi ◽  
G. Arnetoli ◽  
D. Inzitari ◽  
G. Dal Pozzo ◽  
F. Lolli ◽  
...  
Keyword(s):  
Normal Pressure Hydrocephalus ◽  
Normal Pressure ◽  
Csf Shunt ◽  
Communicating Hydrocephalus ◽  
Csf Flow ◽  
Cine Mr ◽  
Csf Shunting ◽  
Before And After ◽  
Flow Void ◽  
Central Flow

Reproducibility of the aqueductal CSF signal intensity on a gradient echo cine-MR sequence exploiting through plane inflow enhancement was tested in 11 patients with normal or dilated ventricles. Seven patients with normal pressure hydrocephalus (NPH) syndrome were investigated with the sequence before and after CSF shunting. Two patients exhibiting central flow void within a hyperintense aqueductal CSF improved after surgery and the flow void disappeared after shunting. One patient with increased maximum and minimum aqueductal CSF signal as compared to 18 healthy controls also improved and the aqueductal CSF signal was considerably decreased after shunting. Three patients with aqueductal CSF values similar to those in the controls did not improve, notwithstanding their maximum aqueductal CSF signals decreasing slightly after shunting. No appreciable aqueductal CSF flow related enhancement consistent with non-communicating hydrocephalus was found in the last NPH patient who improved after surgery. Cine-MR with inflow technique yields a reproducible evaluation of flow-related aqueductal CSF signal changes which might help in identifying shunt responsive NPH patients. These are likely to be those with hyperdynamic aqueductal CSF or aqueductal obstruction.

Impact of duration of symptoms on CSF dynamics in idiopathic normal pressure hydrocephalus

2010 ◽  
Vol 123 (6) ◽  
pp. 414-418 ◽  
Author(s):  
Z. Czosnyka ◽  
B. Owler ◽  
N. Keong ◽  
T. Santarius ◽  
O. Baledent ◽  
...  
Keyword(s):  
Normal Pressure Hydrocephalus ◽  
Normal Pressure ◽  
Idiopathic Normal Pressure Hydrocephalus ◽  
Csf Dynamics ◽  
Duration Of Symptoms

Measurement of Cerebrospinal Fluid Flow: Technique Validation in a Patient with Idiopathic Normal Pressure Hydrocephalus

2005 ◽  
Vol 18 (1) ◽  
pp. 34-36
Author(s):  
A. Romano ◽  
A. Bozzao ◽  
G. Trillò ◽  
M. Bonamini ◽  
F. Fasoli ◽  
...  
Keyword(s):  
Normal Pressure Hydrocephalus ◽  
Phase Contrast ◽  
Normal Pressure ◽  
Third Ventriculostomy ◽  
Csf Flow ◽  
Flow Measurements ◽  
Cerebrospinal Fluid Flow ◽  
Functional Changes ◽  
Before And After ◽  
Long Term Follow Up

This study aimed to assess anatomical and functional changes disclosed by magnetic resonance imaging in a patient with suspect normal pressure hydrocephalus following surgical third ventriculostomy with placement of a ventriculoperitoneal shunt. The patient was investigated by phase contrast sequences to calculate CSF flow in the Sylvian aqueduct before and after the two surgical procedures. In addition, T1-weighted volumetric MPRAGE images were acquired using voxel-based morphometry to study any changes in size of the ventricular system and CSF in the subarachnoid spaces before and after surgery. CSF flow measurements were closely correlated with the patient's clinical course, increased CSF flow coinciding with worsening symptoms, and a decrease in flow noted after surgery. There were no significant changes in the CSF volumes analyzed. Phase contrast technique proved reliable and effective for the purposes of diagnosis and long-term follow-up in patients with suspect normal pressure hydrocephalus eligible for surgery

scholarly journals Accuracy and safety of 1-day external lumbar drainage of CSF for shunt selection in patients with idiopathic normal pressure hydrocephalus

2019 ◽  
Vol 131 (4) ◽  
pp. 1011-1017
Author(s):  
Pasquale Gallina ◽  
Giancarlo Lastrucci ◽  
Saverio Caini ◽  
Nicola Di Lorenzo ◽  
Berardino Porfirio ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Normal Pressure Hydrocephalus ◽  
Surgical Outcome ◽  
Normal Pressure ◽  
Lumbar Drainage ◽  
Test Sensitivity ◽  
Test Outcomes ◽  
External Lumbar Drainage ◽  
Negative Outcome

OBJECTIVEThree to five days of external lumbar drainage (ELD) of CSF is a test for ventriculoperitoneal shunt (VPS) selection in idiopathic normal pressure hydrocephalus (iNPH). The accuracy and complication rates of a shorter (1-day) ELD procedure were analyzed.METHODSData of patients with iNPH who underwent 1-day ELD to be selected to undergo VPS placement with a programmable valve in the period from 2005 to 2015 were reviewed. Patients experiencing VPS complications, valve malfunctioning, or with less than 1 year of follow-up were excluded. The ability of 1-day ELD to predict VPS outcome at 1- and 12-month follow-up was assessed by calculating sensitivity, specificity, and positive and negative predictive values.RESULTSOf 93 patients who underwent 1-day ELD, 3 did not complete the procedure. Of the remaining 90 patients, 2 experienced transient nerve root irritation. Twenty-four patients had negative test outcomes and 66 had positive test outcomes. Nine negative-outcome patients had intraprocedural headache, which showed 37.5% sensitivity (95% confidence interval [CI] 19.5%–59.2%) and 100% specificity (95% CI 93.1%–100%) as predictors of negative 1-day ELD outcome. Sixty-eight patients (6 with negative and 62 with positive outcomes) underwent VPS insertion, which was successful in 0 and 58 patients, respectively, at 1-month follow-up. Test sensitivity and specificity in predicting surgical outcome at 1-month follow-up were 100% (95% CI 92.3%–100%) and 60% (95% CI 27.4%–86.3%), respectively, with 94.1% accuracy (95% CI 85.6–98.4%). Among the 1-day ELD–positive patients, 2 showed no clinical benefit at 12 months follow-up. Test sensitivity and specificity in predicting surgical outcome at 12-month follow-up was 100% (95% CI 92.5%–100%) and 75.0% (95% CI 35.6%–95.5%), respectively, with 97.1% (95% CI 89.8%–99.6%) accuracy.CONCLUSIONSOne-day ELD is a reliable tool in iNPH management, with low complication risk and short trial duration. The test is very consistent in predicting who will have a positive outcome with VPS placement, given the high chance of successful outcome at 1- and 12-month follow-up; negative-outcome patients have a high risk of unsuccessful surgery. Intraprocedural headache is prognostic of 1-day ELD negative outcome.

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