TY - JOUR
T1 - Marked cerebrospinal fluid void
T2 - Indicator of successful shunt in patients with suspected normal-pressure hydrocephalus
AU - Bradley, William G.
AU - Whittemore, Anthony R.
AU - Kortman, Keith E.
AU - Watanabe, Arthur S.
AU - Homyak, Michelle
AU - Teresi, Louis M.
AU - Davis, Stephen J.
PY - 1991/1/1
Y1 - 1991/1/1
N2 - The authors blindly reviewed the charts of 20 patients with normal-pressure hydrocephalus (a disease of unknown cause characterized radiologically as chronic communicating hydrocephalus and clinically by gait apraxia, dementia, and incontinence) who had undergone creation of a ventriculoperitoneal shunt. The initial clinical response to surgery was graded excellent, good, fair, or poor; 5-year follow-up was available in 55% of cases. The magnetic resonance (MR) images obtained in these patients were also blindly reviewed for the magnitude of cerebrospinal fluid (CSF) flow void (graded on the basis of extent rather than degree of signal loss) in the cerebral aqueduct. A significant (P < .003) correlation existed between good or excellent response to surgery and an increased CSF flow void. The presence of associated deep white matter infarction on MR images did not correlate with a poor response to surgery. On the basis of these findings, it is suggested that patients who fulfill the clinical criteria of NPH and have an increased CSF flow void undergo creation of a shunt.
AB - The authors blindly reviewed the charts of 20 patients with normal-pressure hydrocephalus (a disease of unknown cause characterized radiologically as chronic communicating hydrocephalus and clinically by gait apraxia, dementia, and incontinence) who had undergone creation of a ventriculoperitoneal shunt. The initial clinical response to surgery was graded excellent, good, fair, or poor; 5-year follow-up was available in 55% of cases. The magnetic resonance (MR) images obtained in these patients were also blindly reviewed for the magnitude of cerebrospinal fluid (CSF) flow void (graded on the basis of extent rather than degree of signal loss) in the cerebral aqueduct. A significant (P < .003) correlation existed between good or excellent response to surgery and an increased CSF flow void. The presence of associated deep white matter infarction on MR images did not correlate with a poor response to surgery. On the basis of these findings, it is suggested that patients who fulfill the clinical criteria of NPH and have an increased CSF flow void undergo creation of a shunt.
KW - Brain, hydrocephalus, 10.823
KW - Brain, white matter, 13.87
KW - Cerebrospinal fluid, MR studies, 10.1214
KW - Cerebrospinal fluid, flow dynamics, 10.1214
KW - Shunts, ventriculoperitoneal, 10.4513
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U2 - 10.1148/radiology.178.2.1987609
DO - 10.1148/radiology.178.2.1987609
M3 - Article
C2 - 1987609
AN - SCOPUS:0026057420
VL - 178
SP - 459
EP - 466
JO - Radiology
JF - Radiology
SN - 0033-8419
IS - 2
ER -