Cerebrospinal Fluid Flow Study in Differential Diagnosis of Normal Pressure Hydrocephaly and Atrophic Ventriculomegaly

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In this study we investigated value of phase contrast magnetic resonance imaging (MRI) in the differentiation of normal pressure hydrocephaly (NPH) and atrophic ventriculomegaly. We obtained cine MRI images from cerebral aqueduct, and analyzed quantitative cerebrospinal fluid (CSF) flow and output values and graphics that demonstrate variation of CSF flow and output against time during a cardiac cycle. Fourteen patients with ventriculomegaly and 6 normal cases were included into the study. There were hydrocephaly findings in 5 of NPH patients and diffuse cerebral infarcts in one. CSF flow pattern was normal in one case. CSF flow was pronounced on cerebral aqueduct and neighboring ventricles in 2 cases. Systolic CSF flow velocity was increased against resistance in 5 cases of NPH. At least two of characteristic signs of NPH which were dementia, urinary incontinence and ataxia were seen in half of 8 ventriculomegaly patients. CSF flow pattern was normal in 4 cases, whereas multiphasic and slow flow pattern was seen in the remaining patients. In conclusion, phase contrast MRI and CSF flow pattern are radiologic diagnostic methods which may be useful in the differential diagnosis of NPH and atrophic ventriculomegaly and in the evaluation of intracranial pathologies disturbing CSF hemodynamics.

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Phase contrast MRI , normal pressure hydrocephaly , atrophic ventriculomegaly

Pamukkale Medical Journal

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Pamukkale Medical Journal