Neuroimaging in normal pressure hydrocephalus
Autor(a) principal: | |
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Data de Publicação: | 2015 |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Dementia & Neuropsychologia |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1980-57642015000400350 |
Resumo: | ABSTRACT Normal pressure hydrocephalus (NPH) is a syndrome characterized by the triad of gait disturbance, mental deterioration and urinary incontinence, associated with ventriculomegaly and normal cerebrospinal fluid (CSF) pressure. The clinical presentation (triad) may be atypical or incomplete, or mimicked by other diseases, hence the need for supplementary tests, particularly to predict postsurgical outcome, such as CSF tap-tests and computed tomography (CT) or magnetic resonance imaging (MRI). The CSF tap-test, especially the 3 to 5 days continuous external lumbar drainage of at least 150 ml/day, is the only procedure that simulates the effect of definitive shunt surgery, with high sensitivity (50-100%) and high positive predictive value (80-100%). According to international guidelines, the following are CT or MRI signs decisive for NPH diagnosis and selection of shunt-responsive patients: ventricular enlargement disproportionate to cerebral atrophy (Evans index >0.3), and associated ballooning of frontal horns; periventricular hyperintensities; corpus callosum thinning and elevation, with callosal angle between 40º and 90º; widening of temporal horns not fully explained by hippocampal atrophy; and aqueductal or fourth ventricular flow void; enlarged Sylvian fissures and basal cistern, and narrowing of sulci and subarachnoid spaces over the high convexity and midline surface of the brain. On the other hand, other imaging methods such as radionuclide cisternography, SPECT, PET, and also DTI or resting-state functional MRI, although suitable for NPH diagnosis, do not yet provide improved accuracy for identifying shunt-responsive cases. |
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Neuroimaging in normal pressure hydrocephalusnormal pressure hydrocephalusneuroimagingmagnetic resonancecerebrospinal fluid tap testshunt surgeryABSTRACT Normal pressure hydrocephalus (NPH) is a syndrome characterized by the triad of gait disturbance, mental deterioration and urinary incontinence, associated with ventriculomegaly and normal cerebrospinal fluid (CSF) pressure. The clinical presentation (triad) may be atypical or incomplete, or mimicked by other diseases, hence the need for supplementary tests, particularly to predict postsurgical outcome, such as CSF tap-tests and computed tomography (CT) or magnetic resonance imaging (MRI). The CSF tap-test, especially the 3 to 5 days continuous external lumbar drainage of at least 150 ml/day, is the only procedure that simulates the effect of definitive shunt surgery, with high sensitivity (50-100%) and high positive predictive value (80-100%). According to international guidelines, the following are CT or MRI signs decisive for NPH diagnosis and selection of shunt-responsive patients: ventricular enlargement disproportionate to cerebral atrophy (Evans index >0.3), and associated ballooning of frontal horns; periventricular hyperintensities; corpus callosum thinning and elevation, with callosal angle between 40º and 90º; widening of temporal horns not fully explained by hippocampal atrophy; and aqueductal or fourth ventricular flow void; enlarged Sylvian fissures and basal cistern, and narrowing of sulci and subarachnoid spaces over the high convexity and midline surface of the brain. On the other hand, other imaging methods such as radionuclide cisternography, SPECT, PET, and also DTI or resting-state functional MRI, although suitable for NPH diagnosis, do not yet provide improved accuracy for identifying shunt-responsive cases.Academia Brasileira de Neurologia, Departamento de Neurologia Cognitiva e Envelhecimento2015-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1980-57642015000400350Dementia & Neuropsychologia v.9 n.4 2015reponame:Dementia & Neuropsychologiainstname:Associação de Neurologia Cognitiva e do Comportamento (ANCC)instacron:ANCC10.1590/1980-57642015DN94000350info:eu-repo/semantics/openAccessDamasceno,Benito Pereiraeng2015-12-17T00:00:00Zoai:scielo:S1980-57642015000400350Revistahttp://www.demneuropsy.com.br/ONGhttps://old.scielo.br/oai/scielo-oai.php||demneuropsy@uol.com.br1980-57641980-5764opendoar:2015-12-17T00:00Dementia & Neuropsychologia - Associação de Neurologia Cognitiva e do Comportamento (ANCC)false |
dc.title.none.fl_str_mv |
Neuroimaging in normal pressure hydrocephalus |
title |
Neuroimaging in normal pressure hydrocephalus |
spellingShingle |
Neuroimaging in normal pressure hydrocephalus Damasceno,Benito Pereira normal pressure hydrocephalus neuroimaging magnetic resonance cerebrospinal fluid tap test shunt surgery |
title_short |
Neuroimaging in normal pressure hydrocephalus |
title_full |
Neuroimaging in normal pressure hydrocephalus |
title_fullStr |
Neuroimaging in normal pressure hydrocephalus |
title_full_unstemmed |
Neuroimaging in normal pressure hydrocephalus |
title_sort |
Neuroimaging in normal pressure hydrocephalus |
author |
Damasceno,Benito Pereira |
author_facet |
Damasceno,Benito Pereira |
author_role |
author |
dc.contributor.author.fl_str_mv |
Damasceno,Benito Pereira |
dc.subject.por.fl_str_mv |
normal pressure hydrocephalus neuroimaging magnetic resonance cerebrospinal fluid tap test shunt surgery |
topic |
normal pressure hydrocephalus neuroimaging magnetic resonance cerebrospinal fluid tap test shunt surgery |
description |
ABSTRACT Normal pressure hydrocephalus (NPH) is a syndrome characterized by the triad of gait disturbance, mental deterioration and urinary incontinence, associated with ventriculomegaly and normal cerebrospinal fluid (CSF) pressure. The clinical presentation (triad) may be atypical or incomplete, or mimicked by other diseases, hence the need for supplementary tests, particularly to predict postsurgical outcome, such as CSF tap-tests and computed tomography (CT) or magnetic resonance imaging (MRI). The CSF tap-test, especially the 3 to 5 days continuous external lumbar drainage of at least 150 ml/day, is the only procedure that simulates the effect of definitive shunt surgery, with high sensitivity (50-100%) and high positive predictive value (80-100%). According to international guidelines, the following are CT or MRI signs decisive for NPH diagnosis and selection of shunt-responsive patients: ventricular enlargement disproportionate to cerebral atrophy (Evans index >0.3), and associated ballooning of frontal horns; periventricular hyperintensities; corpus callosum thinning and elevation, with callosal angle between 40º and 90º; widening of temporal horns not fully explained by hippocampal atrophy; and aqueductal or fourth ventricular flow void; enlarged Sylvian fissures and basal cistern, and narrowing of sulci and subarachnoid spaces over the high convexity and midline surface of the brain. On the other hand, other imaging methods such as radionuclide cisternography, SPECT, PET, and also DTI or resting-state functional MRI, although suitable for NPH diagnosis, do not yet provide improved accuracy for identifying shunt-responsive cases. |
publishDate |
2015 |
dc.date.none.fl_str_mv |
2015-12-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1980-57642015000400350 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1980-57642015000400350 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/1980-57642015DN94000350 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Academia Brasileira de Neurologia, Departamento de Neurologia Cognitiva e Envelhecimento |
publisher.none.fl_str_mv |
Academia Brasileira de Neurologia, Departamento de Neurologia Cognitiva e Envelhecimento |
dc.source.none.fl_str_mv |
Dementia & Neuropsychologia v.9 n.4 2015 reponame:Dementia & Neuropsychologia instname:Associação de Neurologia Cognitiva e do Comportamento (ANCC) instacron:ANCC |
instname_str |
Associação de Neurologia Cognitiva e do Comportamento (ANCC) |
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ANCC |
institution |
ANCC |
reponame_str |
Dementia & Neuropsychologia |
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Dementia & Neuropsychologia |
repository.name.fl_str_mv |
Dementia & Neuropsychologia - Associação de Neurologia Cognitiva e do Comportamento (ANCC) |
repository.mail.fl_str_mv |
||demneuropsy@uol.com.br |
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1754212931092873216 |