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Rev Esp Med Nucl Imagen Mol 2020 Jul 10. Epub 2020 Jul 10.

Departamento de Neurocirugía, Hospital S. Maria Goretti, Latina, Italia.

Introduction: Our objective was to evaluate the cortical metabolic changes and clinical outcome in patients affected by idiopathic normal pressure hydrocephalus (iNPH) after a placement of ventriculoperitoneal (VP) shunt.

Materials And Methods: 10 patients affected by suspected iNPH underwent a CSF hydrodynamics evaluation based on a lumbar infusion test (LIT). The main selection criterion for surgery was based on intracranial elasticity (IE)>0. Read More

BMC Neurol 2020 Jul 11;20(1):277. Epub 2020 Jul 11.

Department of Neurology, Soonchunhyang University Seoul Hospital, Soonchunhyang University School of Medicine, 59 Daesagwan-ro, Yongsan-gu, Seoul, 04401, Republic of Korea.

Background: Dopamine transporter (DAT) imaging may enable clinicians to discriminate idiopathic normal pressure hydrocephalus (iNPH) from other parkinsonian disorders. However, a specific pattern of dopaminergic loss in DAT imaging of iNPH patients remains to be further elucidated.

Methods: In this preliminary study, 11 patients with iNPH in our hospital between March 2017 and February 2019 were finally enrolled. Read More

Acta Neurol Scand 2020 Jul 3. Epub 2020 Jul 3.

Department of Neurosurgery, Juntendo Tokyo Koto Geriatric Medical Center, Shinsuna Koto-ku, Tokyo, 136-0075, Japan.

Objectives: Comorbidities of idiopathic normal-pressure hydrocephalus (iNPH), such as Alzheimer's disease (AD) and Parkinson's spectrum (PS) disorder, can affect the long-term prognosis of cerebrospinal fluid (CSF) shunting. Therefore, it is important to be able to predict comorbidities in the early stage of the disease. This study aimed to predict the comorbidities of iNPH using neuropsychological tests and cognitive performance evaluation. Read More

Cureus 2020 May 26;12(5):e8295. Epub 2020 May 26.

Internal Medicine, University of Central Florida College of Medicine, Orlando, USA.

Ogilvie's syndrome is a rare postoperative condition commonly referred to as a "colonic pseudo-obstruction" due to the absence of mechanical obstruction. It should be a differential for patients over the age of 60 years who present with nausea, vomiting, and colonic dilatations on imaging. Ogilvie's syndrome following a ventriculoperitoneal (VP) shunt placement is an extremely rare entity with only one other adult patient reported in the English literature. Read More

Ideggyogy Sz 2020 05;73(05-06):177-184

Bezmialem Vakif University, Department of Neurology, Istanbul, Turkey.

Background And Purpose: We aimed to analyze the clinical, laboratory and neuroimaging findings in patients with sporadic Creutzfeldt-Jakob disease (CJD) in a single center as well as to review other published cases in Turkey.

Methods: Between January 1st, 2014 and June 31st, 2017, all CJD cases were evaluated based on clinical findings, differential diagnosis, the previous misdiagnosis, electroencephalography (EEG), cerebrospinal fluid and cranial magnetic resonance imaging (MRI) findings in our center. All published cases in Turkey between 2005-2018 were also reviewed. Read More

Medicine (Baltimore) 2020 Jun;99(25):e20565

Department of Neurosurgery, Shengjing Hospital of China Medical University.

Rationale: Ventriculoperitoneal shunt (VPS) is the most common treatment for idiopathic normal pressure hydrocephalus, a subtype of hydrocephalus characterized by gait disturbance, dementia, and urinary incontinence. However, while the malfunction of VPS is reported at a high rate, the involvement of chronic cholecystitis in shunt malfunction is rare.

Patient Concerns: A 73-year-old woman with idiopathic normal pressure hydrocephalus who received a VPS but subsequently developed chronic cholecystitis. Read More

AJNR Am J Neuroradiol 2020 Jul 11;41(7):1187-1192. Epub 2020 Jun 11.

From the Department of Clinical Neuroscience (J.N., S.A., P.H., M.T., D.F.)

Background And Purpose: Ventricular enlargement in idiopathic normal pressure hydrocephalus is often estimated using the Evans index. However, the sensitivity of the Evans index to estimate changes in ventricular size postoperatively has been questioned. Here, we evaluated the postoperative change in ventricle size in relation to shunt response in patients with idiopathic normal pressure hydrocephalus, by comparing ventricular volume and the Evans index. Read More

BMC Psychiatry 2020 Jun 1;20(1):273. Epub 2020 Jun 1.

Department of Neuropsychiatry, Molecules and Function, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan.

Background: We recently reported that older patients with schizophrenia (SZ) show possible idiopathic normal pressure hydrocephalus (iNPH) more frequently than the general population. In this study, we estimated the prevalence of iNPH in a larger number of older SZ patients and explored useful examination values for diagnosis in the SZ population.

Methods: We enrolled older inpatients with SZ (n = 39, mean age = 68. Read More

Intern Med 2020 May 26. Epub 2020 May 26.

Shimada Hospital, Japan.

An 86-year-old man, who had undergone a lumboperitoneal shunt for idiopathic normal pressure hydrocephalus (iNPH) implanted 4 years earlier showed progressive parkinsonism for the past year. His clinical symptoms, including resting tremor and rapid eye movement sleep behavior disorder, responsiveness to levodopa, and abnormal findings on I-MIBG myocardial scintigraphy and dopamine transporter imaging, indicated that his pathological background of parkinsonism included concomitant synucleinopathy, such as Parkinson's disease or dementia with Lewy bodies, in addition to iNPH. Clinicians should consider the possibility of concomitant proteinopathies and their treatments when clinical symptoms become evident after shunt operations in patients with iNPH. Read More

Front Neurosci 2020 5;14:415. Epub 2020 May 5.

Cardiff University Brain Research Imaging Centre, School of Psychology, Cardiff University, Cardiff, United Kingdom.

Phase contrast MRI (pcMRI) has been used to investigate flow pulsatility in cerebral arteries, larger cerebral veins, and the cerebrospinal fluid (CSF). Such measurements of intracranial pulsatility and compliance are beginning to inform understanding of the pathophysiology of conditions including normal pressure hydrocephalus, multiple sclerosis, and dementias. We demonstrate the presence of flow pulsatility in small cerebral cortical veins, for the first time using pcMRI at 7 T, with the aim of improving our understanding of the hemodynamics of this little-studied vascular compartment. Read More

J Int Neuropsychol Soc 2020 May 20:1-11. Epub 2020 May 20.

Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI.

Objectives: Cognitive impairment and apathy are well-documented features of idiopathic normal pressure hydrocephalus (iNPH). However, research examining other neuropsychiatric manifestations of iNPH is scant, and it is unknown whether the neuropsychiatric presentation differs for iNPH patients with comorbid Alzheimer's disease (AD) versus iNPH without AD. This study aims to advance our understanding of neuropsychiatric syndromes associated with iNPH. Read More

Eur J Neurol 2020 May 16. Epub 2020 May 16.

Department of Neurology and Neurological Science, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan.

Background And Purpose: Idiopathic normal pressure hydrocephalus (iNPH) is a clinical entity without established pathological hallmarks. Previous autopsy studies reported that patients with an antemortem diagnosis of iNPH had a different postmortem diagnosis, commonly progressive supranuclear palsy (PSP). Disproportionately enlarged subarachnoid space hydrocephalus (DESH) has been reported as a characteristic feature of iNPH on magnetic resonance imaging (MRI). Read More

Mov Disord 2020 May 12. Epub 2020 May 12.

Neuroscience Research Center, University "Magna Graecia", Catanzaro, Italy.

Background: Idiopathic normal pressure hydrocephalus and PSP share several clinical and radiological features, making differential diagnosis, at times, challenging.

Objectives: To differentiate idiopathic normal pressure hydrocephalus from PSP using MR volumetric and linear measurements.

Methods: Twenty-seven idiopathic normal pressure hydrocephalus patients, 103 probable PSP patients, and 43 control subjects were consecutively enrolled. Read More

J Stroke Cerebrovasc Dis 2020 Jul 7;29(7):104847. Epub 2020 May 7.

Department of Neurology, University of Health Sciences, Diyarbakir Gazi Yasargil Education and Research Hospital, Diyarbakir, Turkey.

Background: In patients with normal pressure hydrocephalus (NPH), lumbar puncture (LP) is an effective method for assessing both the diagnosis as well as the possible efficacy of ventriculoperitoneal shunting based on symptom improvement. However, it should be considered that there exists a low risk of complications and that these risks may result in morbidity and mortality. We present a patient who developed hematoma in the basal ganglia following LP. Read More

J Neuroimaging 2020 May 6;30(3):303-307. Epub 2020 May 6.

Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden.

Background And Purpose: Cerebral blood flow (CBF) has been reported to increase after shunt surgery in patients with idiopathic normal pressure hydrocephalus (iNPH). The aims of this study were to investigate if CBF, measured using the noninvasive perfusion MRI method arterial spin labeling (ASL), increased after shunt surgery, if postoperative change in CBF correlated with improvement in symptoms, and if baseline CBF data correlated with postoperative outcome.

Methods: Twenty-three patients with iNPH were prospectively included and examined with MRI of the brain and clinical tests of symptoms at baseline. Read More

J Neurol 2020 May 5. Epub 2020 May 5.

Parkinson's Disease and Movement Disorders Unit, IRCCS Mondino Foundation, Via Mondino 2, 27100, Pavia, Italy.

Objective: In this prospective, controlled, monocentric study, we described the clinical and neuroimaging 12-month follow-up of two parallel cohorts of subjects with idiopathic normal pressure hydrocephalus (iNPH), who did or did not undergo lumboperitoneal shunt (LPS).

Methods: We recruited 78 iNPH patients. At baseline, subjects underwent clinical and neuropsychological assessments, 3 T magnetic resonance imaging (MRI), and tap test. Read More

Brain 2020 Jun;143(6):1843-1856

Department of Psychiatry, Kyoto University Graduate School of Medicine, Kyoto, Japan.

Recently, age-related timing dissociation between the superficial and deep venous systems has been observed; this was particularly pronounced in patients with normal pressure hydrocephalus, suggesting a common mechanism of ventriculomegaly. Establishing the relationship between venous drainage and ventricular enlargement would be clinically relevant and could provide insight into the mechanisms underlying brain ageing. To investigate a possible link between venous drainage and ventriculomegaly in both normal ageing and pathological conditions, we compared 225 healthy subjects (137 males and 88 females) and 71 traumatic brain injury patients of varying ages (53 males and 18 females) using MRI-based volumetry and a novel perfusion-timing analysis. Read More

J Am Coll Radiol 2020 May;17(5S):S100-S112

Specialty Chair, Atlanta VA Health Care System and Emory University, Atlanta, Georgia.

Degenerative disease of the central nervous system is a growing public health concern. The primary role of neuroimaging in the workup of patients with probable or possible Alzheimer disease has typically been to exclude other significant intracranial abnormalities. In general, the imaging findings in structural studies, such as MRI, are nonspecific and have limited potential in differentiating different types of dementia. Read More

World Neurosurg 2020 Apr 26. Epub 2020 Apr 26.

IRCSS Istituto delle Scienze Neurologiche di Bologna, UOC Neurochirurgia, Bologna, Italia. Electronic address:

Objective: Diagnosing idiopathic normal pressure hydrocephalus (iNPH) still remains a clinical challenge. The callosal angle (CA) is a widely used neuroradiologic marker for iNPH. However, the relationship of the CA to clinical features has not been well investigated. Read More

Acad Radiol 2020 Apr 21. Epub 2020 Apr 21.

Thayer School of Engineering, Dartmouth College, 14 Engineering Dr, Hanover, NH 03755; Norris Cotton Cancer Center, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire.

Rationale And Objectives: Hydrocephalus (HC) is caused by accumulating cerebrospinal fluid resulting in enlarged ventricles and neurological symptoms. HC can be treated via a shunt in a subset of patients; identifying which individuals will respond through noninvasive imaging would avoid complications from unsuccessful treatments. This preliminary work is a longitudinal study applying MR Elastography (MRE) to HC patients with a focus on normal pressure hydrocephalus (NPH). Read More

Pediatr Emerg Care 2020 Apr 16. Epub 2020 Apr 16.

From the Pediatric Emergency/Trauma Center Saint Joseph Children's Hospital and Medical Center; and Vascular and Interventional Radiology Florida Hospital Carollwood, Tampa, FL.

Objective: The purpose of the study, was to assess the utility of rapid sequence brain magnetic resonance imaging (RS-MRI), as a screening tool to detect gross intracranial pathology in children that present to the emergency department, with a chief complaint of persistent or recurrent headaches. Rapid sequence MRI of the brain is a radiation-free technique that is used to evaluate ventricular size in children with shunted hydrocephalus, who present to the emergency department with symptomatology consistent with shunt malfunction.

Methods: The study evaluated RS-MRI radiographic findings of 105 children that presented to a busy tertiary care pediatric emergency/trauma center between May 1, 2013, and May 31, 2015. Read More

J Clin Med 2020 Apr 11;9(4). Epub 2020 Apr 11.

Department of Neurosurgery, Hualien Tzu Chi Hospital/ Tzu Chi University, Hualien 970, Taiwan.

The diagnosis of idiopathic normal pressure hydrocephalus (iNPH) and the outcome of lumboperitoneal shunt treatment remains to be systematically explored. Here, we aim to evaluate whether the severity of dopaminergic degeneration and white matter small vessel disease could be predictors of outcome for iNPH patients subjected to lumboperitoneal shunt treatment. This is a single center retrospective study with 39 patients with probable iNPH undergoing programmable surgical lumboperitoneal shunt from June 2016 to March 2018 at Hualien Tzu Chi Hospital. Read More

Sci Rep 2020 Apr 9;10(1):6148. Epub 2020 Apr 9.

Department of Neurology in Linköping, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.

Idiopathic normal pressure hydrocephalus (iNPH) is a disorder with unclear pathophysiology. The diagnosis of iNPH is challenging due to its radiological similarity with other neurodegenerative diseases and ischemic subcortical white matter changes. By using Diffusion Tensor Imaging (DTI) we explored differences in apparent diffusion coefficient (ADC) and fractional anisotropy (FA) in iNPH patients (before and after a shunt surgery) and healthy individuals (HI) and we correlated the clinical results with DTI parameters. Read More

Eur Radiol 2020 Aug 3;30(8):4454-4465. Epub 2020 Apr 3.

Department of Neurosurgery, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga, 520-2192, Japan.

Objectives: To evaluate complex CSF movements and shear stress in patients with idiopathic normal pressure hydrocephalus (iNPH) on four-dimensional (4D) flow MRI.

Methods: Three-dimensional velocities and volumes of the reciprocating CSF movements through 12 ROIs from the foramen of Monro to the upper cervical spine were measured in 41 patients with iNPH, 23 patients with co-occurrence of iNPH and Alzheimer's disease (AD), and 9 age-matched controls, using 4D flow imaging and application. Stroke volume, reversed-flow rate, and shear stress were automatically calculated. Read More

World Neurosurg 2020 Jun 19;138:390-397. Epub 2020 Mar 19.

Department of Neurosurgery, National Neuroscience Institute, Singapore, Singapore; Department of Neurosurgery, Duke-NUS Medical School, Singapore, Singapore. Electronic address:

Background: Dilatation of Virchow-Robin spaces (dVRS) have been described in the development of hydrocephalic syndromes. We report an unusual case of a type III dVRS presenting as a mimic of normal pressure hydrocephalus (NPH), due to distortion at the level of the cerebral aqueduct.

Case Description: A 59-year-old woman presented with mild traumatic brain injury and possible NPH, due to a history of progressive gait disturbance, recurrent falls, and cognitive decline over a year, in the context of ventriculomegaly. Read More

Br J Neurosurg 2020 Mar 12:1-4. Epub 2020 Mar 12.

Department of Neurological Surgery, University of Miami Miller School of Medicine, Lois Pope Life Center, Miami, FL, USA.

The authors describe an 82-year-old female with a right frontal ventriculoperitoneal (VP) shunt for long-standing normal pressure hydrocephalus (NPH) who presented with worsening incontinence and gait instability. She was found to have right lateral ventricle collapse around the shunt catheter and subsequently underwent shunt revision, which failed to improve her symptoms. Magnetic resonance imaging (MRI) was obtained on postoperative day two, which demonstrated a ventricular lesion. Read More

World Neurosurg 2020 Jun 2;138:481-484. Epub 2020 Mar 2.

Department of Neurosurgery, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany.

Background: We report the first case of a purely intraventricular calcifying pseudoneoplasm of neuraxis (CAPNON) in the posterior third ventricle.

Case Description: A 63-year-old male without any previous medical history presented with Hakim triad. Imaging showed a calcified lesion of the posterior third ventricle with hydrocephalus. Read More

BMC Neurol 2020 Feb 12;20(1):53. Epub 2020 Feb 12.

Department of Neurology, First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003, China.

Background: Myotonic dystrophy type 1 (DM1) is the most common disease that can cause muscle weakness and atrophy among adults. Normal pressure hydrocephalus (NPH) is characterized by the triad of gait disturbance, cognitive impairment and urinary incontinence. The association between DM1 and NPH is extremely rare. Read More

J Neurol 2020 May 29;267(5):1389-1400. Epub 2020 Jan 29.

ToNIC UMR 1214, INSERM, Toulouse, France.

Frailty is known to predict dementia. However, its link with neurodegenerative alterations of the central nervous system (CNS) is not well understood at present. We investigated the association between the biomechanical response of the CNS and frailty in older adults suspected of normal pressure hydrocephalus (NPH) presenting with markers of multiple co-existing pathologies. Read More

Neurosurg Rev 2020 Jan 24. Epub 2020 Jan 24.

Department of Neurosurgery and Neurooncology, Military University Hospital and Charles University, First Medical Faculty, U Vojenské nemocnice 1200/1, 162 00, Prague 6, Czech Republic.

To assess automated volumetric analysis as a potential presurgical diagnostic tool or as a method to potentially shed light on normal pressure hydrocephalus (NPH) pathophysiology. MRI imaging according to our protocol was performed in 29 NPH patients, 45 non-NPH (but suspected) patients and 15 controls. Twenty patients underwent a second MRI 3 months after ventriculoperitoneal (VP) shunt surgery. Read More

J Comput Assist Tomogr 2020 Jan/Feb;44(1):59-64

From the Departments of Radiology, Biostatistics and Medicine Informatics.

Purpose: The aim of this study was to investigate correlations between clinical symptoms, cerebrospinal fluid flow metrics, hydrocephalus index, small-vessel disease, and white matter (WM) changes in normal pressure hydrocephalus (NPH).

Methods: Aquaductal stroke volumes (ASVs), Z Evans index, Fazekas grading (FG), and diffusion tensor imaging measurements from WM bundles of 37 patients with NPH were retrospectively evaluated. Mann-Whitney U test between clinical symptoms and other variables and Spearman ρ correlations for relationships between variables and Kruskal-Wallis to correlate FG with nonclinical variables were used. Read More

Radiographics 2020 Jan-Feb;40(1):122-140

From the Department of Diagnostic Radiology, Mount Sinai Medical Center, 4300 Alton Rd, Miami Beach, FL 33140.

With phase-contrast imaging, the MRI signal is used to visualize and quantify velocity. This imaging modality relies on phase data, which are intrinsic to all MRI signals. With use of bipolar gradients, degrees of phase shift are encoded and in turn correlated directly with the velocity of protons. Read More

Case Rep Crit Care 2019 10;2019:1468704. Epub 2019 Dec 10.

Consultant Intensivist, National Hospital of Sri Lanka, Colombo, Sri Lanka.

Cerebral venous sinus thrombosis associated with acute hydrocephalus and periventricular leukoencephalopathy is a challenging combination, in a critically ill with deteriorating neurology. We report a case of a young man with acute onset neuropsychiatric manifestations, admitted to the intensive care unit. He was found to have widespread cerebral venous sinus thrombosis, hyperintensities in basal ganglia, and acute hydrocephalus in magnetic resonance imaging, necessitating cerebrospinal fluid diversion, by way of an external ventricular drain and therapeutic anticoagulation. Read More

J Neurosurg Spine 2019 Dec 20:1-6. Epub 2019 Dec 20.

Objective: One of the technical problems encountered in performing lumboperitoneal shunt (LPS) surgery involves operative positioning of the patient. To insert the spinal catheter into the subarachnoid lumbar space, LPS is usually performed with the patient in the lateral decubitus position. However, laparotomy around the periumbilical region, especially in obese patients in the lateral decubitus position, can be quite difficult. Read More

EJNMMI Res 2019 Dec 16;9(1):111. Epub 2019 Dec 16.

Department of Radiology, Kindai University Faculty of Medicine, Osakasayama, Osaka, Japan.

Background: Decreased cerebral glucose metabolism has been reported in idiopathic normal pressure hydrocephalus (iNPH). However, the timing of appearance in the preclinical stage of iNPH remains unknown. Herein, we evaluated the changes in regional cerebral glucose metabolism with respect to the characteristic morphologic features of iNPH. Read More

Gerontol Geriatr Med 2019 Jan-Dec;5:2333721419889739. Epub 2019 Nov 28.

Oslo University Hospital, Rikshospitalet, Norway.

Accumulation in the brain of metabolic waste products such as amyloid-β and hyperphosporylated tau (tau) is a hallmark of dementia (e.g., Alzheimer's disease). Read More

J Neurol Sci 2020 Jan 25;408:116510. Epub 2019 Oct 25.

Memory Ageing and Cognition Centre, National University Health System, Singapore; Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.

Introduction: Disproportionately Enlarged Subarachnoid space Hydrocephalus (DESH) is considered as an important imaging feature of idiopathic normal pressure hydrocephalus (iNPH).

Method: Subjects aged 60 and over in a memory clinic and a community-based cohort were assessed for the presence of ventriculomegaly, Sylvian dilatation, and high convexity tightness by neuroimaging, and a clinical triad of iNPH symptoms, i.e. Read More

World Neurosurg 2020 Mar 2;135:176-179. Epub 2019 Dec 2.

Department of Neurological Surgery, University of Massachusetts Medical School, Worcester, Massachusetts, USA; Adult Hydrocephalus Program, Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA. Electronic address:

Background: Idiopathic normal pressure hydrocephalus (iNPH) is a disorder of aging that is characterized by enlarged cerebral ventricles, gait apraxia, dementia, and urinary incontinence. iNPH is frequently misdiagnosed, in part because the symptoms resemble other neurological disorders, and because other associated symptoms have not been fully characterized. Importantly, iNPH has not previously been associated with stuttering, and shunting has not been shown to alleviate the symptom of stuttering. Read More

Neurosurg Focus 2019 12;47(6):E16

4Division of Pediatric Neuroradiology, Department of Radiology, Lucile Packard Children's Hospital, Stanford University School of Medicine, Stanford, California.

Objective: While conventional imaging can readily identify ventricular enlargement in hydrocephalus, structural changes that underlie microscopic tissue injury might be more difficult to capture. MRI-based diffusion tensor imaging (DTI) uses properties of water motion to uncover changes in the tissue microenvironment. The authors hypothesized that DTI can identify alterations in optic nerve microstructure in children with hydrocephalus. Read More

Neuroradiol J 2020 Feb 27;33(1):66-74. Epub 2019 Nov 27.

Department of Radiology, Section of Neuroradiology, San Donato Hospital, Italy.

Purpose: Diffusion tensor imaging is a magnetic resonance technique that provides information about the orientation and anisotropy of the white matter tracts. The aim of this study was to analyse diffusion tensor imaging quantitative parameters in idiopathic normal pressure hydrocephalus patients, in order to determine whether this method could correlate to clinical scores and cerebrospinal fluid flowmetry data.

Methods And Materials: Fifteen consecutive patients with idiopathic normal pressure hydrocephalus and 15 age-matched controls underwent cerebrospinal fluid flowmetry and diffusion tensor imaging using a 1. Read More

Neurol Clin 2020 02 7;38(1):171-183. Epub 2019 Nov 7.

Dent Neurologic Institute, 3980A Sheridan Drive, Amherst, NY 14226, USA.

Since the clinical syndrome of progressive gait disturbance, urinary incontinence, and dementia in the setting of occult hydrocephalus responsive to cerebrospinal fuid (CSF) shunting was first reported in 1965, the existence of a potentially reversible cause for a form of a dementia illness has generated extensive clinical research and numerous clinical trials. Idiopathic normal pressure hydrocephalus (iNPH) continues to be a heavily debated clinical syndrome. This paper reviews guidelines and imaging findings most often associated with iNPH and the relationship of the neuroimaging findings to some of the theories for this complex syndrome. Read More

J Neurol Sci 2020 Jan 18;408:116581. Epub 2019 Nov 18.

Department of Imaging and Functional Medicine, University Hospital of Umeå, Daniel Naezéns väg, 90737 Umeå, Sweden. Electronic address:

Purpose: Numerous radiological measures have been proposed as imaging biomarkers of idiopathic normal pressure hydrocephalus (iNPH), however, the number of studies systematically comparing their diagnostic values remains limited. The study objective was to compare the diagnostic performance of fifteen cross-sectional imaging iNPH biomarkers.

Materials And Methods: Eighty subjects were prospectively enrolled in the study: 35 subjects with clinically confirmed iNPH and 45 matched healthy controls (HC). Read More

Neurology 2020 02 20;94(5):e549-e556. Epub 2019 Nov 20.

From the Departments of Health Sciences Research (J.E.C., C.T.B.) and Neurology (N.R.G.-R.), Mayo Clinic, Jacksonville, FL; and Departments of Radiology (J.L.G., C.R.J.) and Neurology (D.T.J., J.G.-R., D.S.K., B.F.B., R.C.P.), Mayo Clinic, Rochester, MN.

Objective: To compare the clinical utility of volume-based ratios with the standard linear ratio of Evans index (EI) by examining their associations with gait, cognition, and other patient and imaging variables.

Methods: From MRI scans of 1,774 participants in the Mayo Clinic Study of Aging, we calculated 3 ventricle size measures: Evan index (frontal horn width divided by widest width of skull inner table), total ventricular volume, and frontal horn volume as ratios of total intracranial volume. Gait was measured by a timed 25-foot walk and cognition by a composite of psychometric tests. Read More

Neurobiol Dis 2020 02 13;134:104677. Epub 2019 Nov 13.

Department of Neurology, University Medical Center Goettingen, Germany; DZNE, German Center for Neurodegenerative Diseases Goettingen, Germany; Cluster of Excellence Nanoscale Microscopy and Molecular Physiology of the Brain (CNMPB), Goettingen, Germany; Center for Biostructural Imaging of Neurodegeneration (BIN), University Medical Center Goettingen, Germany; Department of Neurology, Klinikum rechts der Isar, School of Medicine, Technical University Munich, 81675 Munich, Germany. Electronic address:

The aim of the study was to validate a predictive biomarker machine learning model for the classification of Parkinson's disease (PD) and age-matched controls (AMC), based on bioelement abundance in the cerebrospinal fluid (CSF). For this multicentric trial, participants were enrolled from four different centers. CSF was collected according to standardized protocols. Read More

Neurol Sci 2020 Feb 8;41(2):403-409. Epub 2019 Nov 8.

Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Science/Peking Union Medical College, 1st, Dongcheng District, Beijing, 100730, China.

Aim: Adult-onset leukoencephalopathy with axonal spheroids and pigmented glia (ALSP) is an inherited rare disease affecting young adults. We present the clinical, imaging, and neuropathological results of our case series, emphasizing biopsy histology combined with clinical information will increase the accuracy of early diagnosis.

Methods: In total, 4 females and 2 male ALSP patients with onset at ages 24-45 years were enrolled. Read More

Neurol Med Chir (Tokyo) 2019 Dec 17;59(12):498-503. Epub 2019 Oct 17.

Department of Neurosurgery, Okegawa Clinic.

This study consisted of 29 patients with idiopathic normal pressure hydrocephalus (iNPH) who underwent lumbosubarachnoid-lumboepidural (L-L) shunting under local anesthesia in accordance with our surgical indications of L-L shunting. (1) CSF absorption within the lumbar epidural space and shunt clearance were confirmed in all patients after operation. (2) Shunt responders (R) were 25 of 29 cases (86. Read More

J Pak Med Assoc 2019 Aug;69(Suppl 3)(8):S78-S82

Al-Mustansiriya University, Baghdad, Iraq.

Objective: To assess the value of phase contrast magnetic resonance imaging cerebrospinal fluid flowmetry in differentiating between normal pressure hydrocephalus and involutional atrophy.

Methods: The descriptive case-control study was conducted at the Al-Yarmouk Teaching Hospital, Baghdad, Iraq, from April to December 2017, and comprised patients with normal pressure hydrocephalus and involutional brain changes. Healthy volunteers were included as controls. Read More

Neurol Med Chir (Tokyo) 2019 Nov 3;59(11):436-443. Epub 2019 Oct 3.

Department of Immunology, Osaka City University Graduate School of Medicine.

Disproportionately enlarged subarachnoid-space hydrocephalus (DESH) findings are often reported as characteristic radiological features of idiopathic normal pressure hydrocephalus (iNPH). However, the process of development of DESH remains unclear. The aim of the present study was to determine the dynamic deforming process and pathophysiology of iNPH. Read More

PLoS One 2019 27;14(9):e0222725. Epub 2019 Sep 27.

Department of Veterinary Clinical Sciences, Small Animal Clinic - Neurosurgery, Neuroradiology and Clinical Neurology, Justus-Liebig-University, Giessen, Germany.

Collapse of the lateral cerebral ventricles after ventriculo-peritoneal drainage is a fatal complication in dogs with internal hydrocephalus. It occurs due to excessive outflow of cerebrospinal fluid into the peritoneal cavity (overshunting). In most shunt systems, one-way valves with different pressure settings regulate flow into the distal catheter to avoid overshunting. Read More