normal pressure hydrocephalus radiology

2008;29 (1): 192-7. 24. Kitagaki H, Mori E, Ishii K, Yamaji S, Hirono N, Imamura T. CSF spaces in idiopathic normal pressure hydrocephalus: morphology and volumetry. 23. Although CT is able to visualize the anatomical changes, it is inferior to MRI. In future studies, we plan to incorporate sulcal morphologic analysis into our predictive model and discriminate between AD, NPH, and comorbid categories. American journal of neuroradiology. AJNR Am J Neuroradiol 36:831–838 CrossRef PubMed Google Scholar Bradley WG, Kortman KE, Burgoyne B (1986) Flowing cerebrospinal fluid in normal and hydrocephalic states: appearance on … Predicting the results of cerebrospinal fluid shunting. 7: 18. All volumes are in cubic centimeters. Nervenarzt. Background: Various radiological markers have been proposed for diagnostics in idiopathic normal pressure hydrocephalus (iNPH). Thus, our proposed prediction model on the basis of CA and EI may serve as a screening tool to help the radiologist identify patients with possible NPH and recommend further volumetric assessment. Differences in the hippocampus across the three groups were significant (F = 28.49; P < .0001). 31. Each ADNI MR imaging examination had to pass screening for blurring, ghosting, and flow artifacts; image homogeneity; signal-to-noise ratio; susceptibility artifacts; and gray-white cerebrospinal fluid contrast. 2000;21 (9): 1586-90. For comparison between 1.5-T versus 3-T magnetic field strength, we randomly selected five individuals from the ADNI database who underwent two MR examinations within 6 months: one examination with a 1.5-T imager (Avanto; Siemens) and the second with a 3-T imager (Prisma; Siemens). (2003) ISBN:0781732522. Unlike the model based on the volumetric measures, the model based on CA and EI performs poorly in classifying both patients with AD and HC volunteers. 13. Radiology. (2008) European radiology. 2019, Parkinsonism & Related Disorders, Vol. Mean volume of the hippocampus in patients with AD was less than mean volume of the hippocampus in HC and NPH groups (Tukey honest significant difference test, P < .01). Holodny AI, George AE, de Leon MJ, Golomb J, Kalnin AJ, Cooper PR. Iseki C, Kawanami T, Nagasawa H, Wada M, Koyama S, Kikuchi K, Arawaka S, Kurita K, Daimon M, Mori E, Kato T. Asymptomatic ventriculomegaly with features of idiopathic normal pressure hydrocephalus on MRI (AVIM) in the elderly: a prospective study in a Japanese population. Table 1 and Figure 4 show group distribution of gray matter, white matter, ventricular, and hippocampal volumes. 52 (11): 775-809. Normal pressure hydrocephalus (NPH) is characterized by gait disturbance, mental deterioration, and urinary incontinence in patients with an enlarged ventricular system and normal CSF pressure .An important pathophysiological feature of NPH is dysfunctional CSF dynamics with reduced absorption through the arachnoid villi, compensatory CSF flow into the periventricular white matter, … Bradley WG, Scalzo D, Queralt J, et al. Normal-pressure hydrocephalus. Shprecher D, Schwalb J, Kurlan R. Normal pressure hydrocephalus: diagnosis and treatment. The slow enlargement of the ventricles means that the fluid pressure in the brain may not be as high as in other types of hydrocephalus. Upper midbrain profile sign and cingulate sulcus sign: MRI findings on sagittal images in idiopathic normal-pressure hydrocephalus, Alzheimer's disease, and progressive supranuclear palsy. Mobility problems, dementia and urinary incontinence are the main symptoms of … Unable to process the form. Figure 1: By using MPRAGE sequences, a coronal plane was obtained at the level of the posterior commissure from each observer’s best approximation (blue and red lines, left), with plane oriented 90° to anterior-posterior commissure line. In our patients, functional ambulation performance was determined by using the GaitRite system (CIR Syst… This article is focused on idiopathic cases. These measures for both AD and HC groups were obtained directly from the ADNI database, which used the same software (FreeSurfer 5.1) to perform these segmentations. Note—Data in parentheses are numerator and denominator unless otherwise indicated. In our patients, functional ambulation performance was determined by using the GaitRite system (CIR Systems, Havertown, Pa) (21). Extensive demographics, family history, and medical history are available for all ADNI participants. The most recent advance in shunt valve design is the development of adjustable or programmable valves. Gait disorders are the initial manifestations; other symptoms appear as the disease progresses (2). It is felt by some authors that AVIM is actually a pre-clinical form of iNPH 30. (2009) ISBN:3211855785. The range of areas under the curve was 0.96–0.97, depending on the observer. EI is a component of the NPH diagnostic criteria in both the United States (16) and Japan (14). Springer. NPH was considered to be a positive finding; non-NPH (ie, patients with AD and HC patients) was considered to be a negative finding. Krauss JK, Regel JP, Vach W et-al. Ringstad G, Emblem KE, Geier O, Alperin N, Eide PK. There are several limitations to this study that need to be considered when interpreting the data. We used the cutoff of 0.5 to predict the outcome. There was no difference in mean white matter volume between groups (F = 1.5; P = .239). We examined the usefulness of radiological markers in the diagnostics and prediction of shunt response in iNPH. There is a general agreement that NPH is complex and underdiagnosed, and a detailed characterization of its severity is lacking (2). ADNI data are disseminated by the Laboratory for Neuro Imaging at the University of Southern California. The quantitative functional ambulation performance gait score showed a significant (P = .02) improvement from 71.1 ± 16.3 (standard deviation) before shunt to 80.3 ± 14.5 after shunt. 6. LeMay M, New PF. Images of control patients (both HC patients and patients with AD from ADNI) were acquired with a variety of 1.5-T and 3-T MR imaging systems that used the same T1-weighted MPRAGE sequence. For CA, a cutoff of 100° was 88.7% (282 318) accurate for identification of patients with NPH, and measurements below the cutoff suggested NPH. 1968;2 (4): 307-27. Several signs of normal pressure hydrocephalus: narrow callosal angle of 74 degrees; coronal T2: periventricular edema (green arrows) sagittal T1: wide cerebral aqueduct (red arrow) and normal floor of the 3rd ventricle (green arrow) axial T2: increased flow void in the aqueduct (green arrow) axial T2: narrow parasagittal CSF fissures (green arrows) 1999;11 (3): 297-300. {"url":"/signup-modal-props.json?lang=us\u0026email="}, {"containerId":"expandableQuestionsContainer","displayRelatedArticles":true,"displayNextQuestion":true,"displaySkipQuestion":true,"articleId":6306,"mcqUrl":"https://radiopaedia.org/articles/normal-pressure-hydrocephalus/questions/1358?lang=us"}. Patients who meet one of the criteria should be categorized as probable NPH. Bradley WG, Scalzo D, Queralt J et-al. The Akaike information criterion was used as a measure of the relative quality of a model that included a penalty for increasing the number of free variables to discourage overfitting. 277 (1-2): 54-7. Communicating hydrocephalus with reversible cognitive impairment. Patients with AD and HC volunteers were selected from the ADNI database, which is a longitudinal, multicenter study designed to develop multimodality biomarkers for the early detection and tracking of AD. ICCs showed very good interobserver agreement for CA (ICC, 0.92; 95% confidence interval: 0.89, 0.95) and good agreement for EI (ICC, 0.81; 95% confidence interval: 0.73, 0.87). The reformatted images were directly provided to the observers. and family’s subjective impression of gait improvement) (n = 101); (b) had available preoperative 1.5-T or 3-T MR examination performed locally that included high-resolution magnetization-prepared rapid gradient-echo (MPRAGE) sequence (n = 60); (c) successfully completed ventricular shunt placement procedure at our institution and subsequently demonstrated significant clinical improvement (n = 54); and (d) were free of comorbidities such as cerebrovascular disease, coexisting intracranial mass lesion, or previous craniectomy identified by a neuroradiologist (A.G.). For example, when neuroradiologists were asked to independently evaluate T1-weighted brain magnetic resonance (MR) images as either of patients with NPH, patients with AD, or elderly healthy control (HC) volunteers, the diagnostic accuracy was 68%–78%, and the agreement was only fair (intraclass correlation coefficient [ICC], 0.51; 95% confidence interval: 0.34, 0.66) (11). [Idiopathic normal-pressure hydrocephalus. 23. A classic neurological sign in NPH is magnetic gait, where the patients' feet appear to be magnetically attached to the floor. 17. The regression model that used volumetric predictors of gray matter and white matter was 94.3% accurate. Focal dilation and paradoxical collapse of cortical fissures and sulci in patients with normal-pressure hydrocephalus. Curr Neurol Neurosci Rep. 2008;8 (5): 371-6. American journal of neuroradiology. The finding of DESH without neurologic symptoms has been termed asymptomatic ventriculomegaly with features of idiopathic normal pressure hydrocephalus on MRI (AVIM) 1. Magnetic resonance (MR) examinations performed before surgery (within 1–5 months of the MR examination) in 36 shunt-responsive patients with normal-pressure hydrocephalus (NPH; mean age, 75 years; age range, 58–87 years; 26 men, 10 women) and MR examinations of age- and sex-matched patients with Alzheimer disease (n = 34) and healthy control volunteers (n = 36) were studied. Analysis of variance was used to compare mean values of individual variables across study groups. One of the outcomes of the logistic regression model is the estimated probability of NPH for each patient. 18. J Neurosurg. 21. Similarly, our study did not address patients with NPH with smaller than average ventricles. 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