Neuroimaging in normal pressure hydrocephalus

Detalhes bibliográficos
Autor(a) principal: Damasceno,Benito Pereira
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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spelling 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)
instacron_str ANCC
institution ANCC
reponame_str Dementia & Neuropsychologia
collection 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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