Preoperative and postoperative1H-MR spectroscopy changes in frontal deep white matter and the thalamus in idiopathic normal pressure hydrocephalus

2012 ◽  
Vol 84 (2) ◽  
pp. 188-193 ◽  
Author(s):  
Fredrik Lundin ◽  
Anders Tisell ◽  
Göran Leijon ◽  
Olof Dahlqvist Leinhard ◽  
Leif Davidsson ◽  
...  
Keyword(s):  
White Matter ◽  
Normal Pressure Hydrocephalus ◽  
Mr Spectroscopy ◽  
Normal Pressure ◽  
Idiopathic Normal Pressure Hydrocephalus ◽  
Deep White Matter

scholarly journals Increased interstitial fluid in periventricular and deep white matter hyperintensities in patients with suspected idiopathic normal pressure hydrocephalus

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Alexander Rau ◽  
Marco Reisert ◽  
Elias Kellner ◽  
Jonas A. Hosp ◽  
Horst Urbach ◽  
...  
Keyword(s):  
White Matter ◽  
Water Content ◽  
Normal Pressure Hydrocephalus ◽  
Interstitial Fluid ◽  
White Matter Hyperintensities ◽  
Free Water ◽  
Normal Pressure ◽  
Idiopathic Normal Pressure Hydrocephalus ◽  
Imaging Features ◽  
Deep White Matter

AbstractPeriventricular white matter changes are common in patients with idiopathic normal pressure hydrocephalus (iNPH) and considered to represent focally elevated interstitial fluid. We compared diffusion measures in periventricular hyperintensities in patients with imaging features of iNPH to patients without. The hypothesis is that periventricular hyperintensities in patients with presumed iNPH show higher water content than in patients without imaging features of iNPH. 21 patients with iNPH Radscale 7–12 (“high probability of iNPH”) and 10 patients with iNPH Radscale 2–4 (“low probability of iNPH”) were examined with a neurodegeneration imaging protocol including a diffusion microstructure imaging sequence. Periventricular hyperintensities and deep white matter hyperintensities were segmented and diffusion measures were compared. In patients with imaging features of iNPH, the free water content in periventricular hyperintensities was significantly higher compared to the control group (p = 0.005). This effect was also detectable in deep white matter hyperintensities (p = 0.024). Total brain volumes and total gray or white matter volumes did not differ between the groups. Periventricular cap free water fraction was highly discriminative regarding patients with presumed iNPH and controls with an ROC AUC of 0.933. Quantitative diffusion microstructure imaging shows elevated water content in periventricular hyperintensities in patients with imaging features of iNPH, which could be the imaging correlate for pathologic fluid accumulation and may be used as an imaging biomarker in the future.

scholarly journals Idiopathic Normal Pressure Hydrocephalus: Cerebral Perfusion Measured with pCASL before and Repeatedly after CSF Removal

2014 ◽  
Vol 34 (11) ◽  
pp. 1771-1778 ◽  
Author(s):  
Johan Virhammar ◽  
Katarina Laurell ◽  
André Ahlgren ◽  
Kristina Giuliana Cesarini ◽  
Elna-Marie Larsson
Keyword(s):  
White Matter ◽  
Normal Pressure Hydrocephalus ◽  
Intraclass Correlation ◽  
Correlation Coefficients ◽  
Normal Pressure ◽  
Idiopathic Normal Pressure Hydrocephalus ◽  
Regional Variability ◽  
Mri Scans ◽  
Magnetic Resonance Imaging Mri ◽  
Gait Function

Pseudo-continuous arterial spin labeling (pCASL) measurements were performed in 20 patients with idiopathic normal pressure hydrocephalus (iNPH) to investigate whether cerebral blood flow (CBF) increases during the first 24 hours after a cerebrospinal fluid tap test (CSF TT). Five pCASL magnetic resonance imaging (MRI) scans were performed. Two scans were performed before removal of 40 mL CSF, and the other three at 30 minutes, 4 hours, and 24 hours, respectively after the CSF TT. Thirteen different regions of interest (ROIs) were manually drawn on coregistered MR images. In patients with increased CBF in lateral and frontal white matter after the CSF TT, gait function improved more than it did in patients with decreased CBF in these regions. However, in the whole sample, there was no significant increase in CBF after CSF removal compared with baseline investigations. The repeatability of CBF measurements at baseline was high, with intraclass correlation coefficients of 0.60 to 0.90 for different ROIs, but the median regional variability was in the range of 5% to 17%. Our results indicate that CBF in white matter close to the lateral ventricles plays a role in the reversibility of symptoms after CSF removal in patients with iNPH.

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