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Curr Drug Targets 2019 Feb 14. Epub 2019 Feb 14.

Department of Radiology, Baoji Center Hospital No. 8 Jiang Tan Road, Baoji 721008, Shaanxi. China.

Background: Normal pressure hydrocephalus (NPH) is a critical brain disorder in which excess cerebrospinal fluid (CSF) is accumulated in the brain's ventricles causing damage or disruption of the brain tissues. Amongst various signs and symptoms, difficulty in walking, blurred speech, impaired decision making and critical thinking, and loss of bladder and bowl control are considered the hallmark features of NPH.

Objective: The current review was aimed to present a comprehensive overview and critical appraisal of majorly employed neuroimaging techniques for rational diagnosis and effective monitoring of effectiveness of employed therapeutic intervention for NPH. Read More

Curr Drug Targets 2019 Feb 14. Epub 2019 Feb 14.

Department of Radiology, Baoji Center Hospital No. 8 Jiang Tan Road, Baoji 721008, Shaanxi. China.

Background: Normal pressure hydrocephalus (NPH) is a critical brain disorder in which excess cerebrospinal fluid (CSF) is accumulated in the brain's ventricles causing damage or disruption of the brain tissues. Amongst various signs and symptoms, difficulty in walking, blurred speech, impaired decision making and critical thinking, and loss of bladder and bowl control are considered the hallmark features of NPH.

Objective: The current review was aimed to present a comprehensive overview and critical appraisal of majorly employed neuroimaging techniques for rational diagnosis and effective monitoring of effectiveness of employed therapeutic intervention for NPH. Read More

Continuum (Minneap Minn) 2019 Feb;25(1):165-186

Purpose Of Review: Since it was first described in 1965, normal pressure hydrocephalus (NPH) has been a controversial subject. New studies have shed light on its epidemiology and pathogenesis and provided objective ways to measure outcome in patients with NPH. Neuroimaging has improved and allows better recognition of both NPH and the presence of overlapping diseases RECENT FINDINGS: Several recent epidemiologic studies confirm that NPH is a rare disease, but the presence of large ventricles is a common finding with aging. Read More

Front Med (Lausanne) 2018 10;5:357. Epub 2019 Jan 10.

Department of Neurosurgery, National Neuroscience Institute, Singapore, Singapore.

Normal pressure hydrocephalus (NPH) is a syndrome comprising gait disturbance, cognitive decline and urinary incontinence that is an unique model of reversible brain injury, but it presents as a challenging spectrum of disease cohorts. Diffusion Tensor Imaging (DTI), with its ability to interrogate structural white matter patterns at a microarchitectural level, is a potentially useful tool for the confirmation and characterization of disease cohorts at the clinical-research interface. However, obstacles to its widespread use involve the need for consistent DTI analysis and interpretation tools across collaborator sites. Read More

J Neurol Sci 2019 Jan 16;398:9-15. Epub 2019 Jan 16.

Interfaculty Initiative in Information Studies / Institute of Industrial Science, The University of Tokyo, Tokyo, Japan. Electronic address:

Purpose: Brain interstitial fluid plays an important role in the excretion of metabolic waste products into the cerebrospinal fluid through perivascular spaces (PVS). To investigate the normal function of PVS in healthy elderly individuals, we assessed the relationship between PVS and white matter hyperintensity (WMH) on MRI in two locations.

Methods: This study included 296 healthy individuals aged ≥60 years without a history of brain disease who underwent brain MRI. Read More

J Neurosurg Pediatr 2019 Jan 4:1-5. Epub 2019 Jan 4.

3Neurointerventional Radiology, Boston Children's Hospital, Boston, Massachusetts.

Pediatric hydrocephalus is a well-studied and still incompletely understood entity. One of the physiological means by which hydrocephalus and intracranial hypertension evolve is through perturbations to normal vascular dynamics. Here the authors report a unique case of an extracranial vascular anomaly resulting in persistently elevated intracranial pressures (ICPs) independent of CSF diversion in a patient with a Joubert syndrome-related disorder. Read More

Surg Neurol Int 2018 28;9:238. Epub 2018 Nov 28.

Department of Pediatric Neurosurgery, Dana Children's Hospital, Tel-Aviv Medical Center, Tel-Aviv, Israel.

Background: Ventriculoperitoneal shunting (VPS) is considered a risk factor for developing subdural hematomas (SDH). Treating cases of acute SDH (aSDH) in shunted normal-pressure hydrocephalus (NPH) patients can be challenging, and data in this field are scarce. We report our experience treating shunted NPH patients presenting with aSDH. Read More

eNeurologicalSci 2019 Mar 19;14:21-23. Epub 2018 Nov 19.

Department of Neurology, University of Tsukuba, 1-1-1 Tenodai, Tsukuba-city, Japan.

Meningeal carcinomatosis is a unique and rare form of metastasis observed in patients with malignant tumours. Diagnosis is simple when the primary lesion of the malignant tumour is clear, and when multiple miliary lesions are confirmed via cranial contrast MRI; however, many patients exhibit atypical imaging findings. In the present report, we discuss the case of a 72-year-old man who presented with subacute consciousness impairment and MRI findings suggestive of progressive, bilateral leukoencephalopathy-like lesions around the ventricles. Read More

AJNR Am J Neuroradiol 2019 Jan 6;40(1):74-79. Epub 2018 Dec 6.

From the Hydrocephalus Research Unit (S.A., M.W., P.H., C.W., M.T.), Department of Clinical Neuroscience and Rehabilitation, Institute of Neuroscience and Physiology.

Background And Purpose: Several studies have evaluated the use of MR imaging markers for the prediction of outcome after shunt surgery in idiopathic normal pressure hydrocephalus with conflicting results. Our aim was to investigate the predictive value of a number of earlier proposed morphologic MR imaging markers in a large group of patients with idiopathic normal pressure hydrocephalus.

Materials And Methods: One hundred sixty-eight patients (mean age, 70 ± 9. Read More

Neurospine 2018 Oct 2. Epub 2018 Oct 2.

Department of Neurosurgery, Tohoku University, Graduate School of Medicine, Sendai, Japan.

The present study reports the case of an 81-year-old woman who underwent lumboperitoneal shunt (LPS) placement for idiopathic normal-pressure hydrocephalus. After LPS placement, the patient presented with radicular pain. A computed tomography scan revealed that the intradural lumbar catheter was tangled at the T11 vertebra; therefore, we decided to remove the catheter under local anesthesia. Read More

Front Aging Neurosci 2018 15;10:356. Epub 2018 Nov 15.

Department of Radiology, Huashan Hospital of Fudan University, Shanghai, China.

: Idiopathic normal pressure hydrocephalus (iNPH) is known as a treatable form of dementia. Network analysis is emerging as a useful method to study neurological disorder diseases. No study has examined changes of structural brain networks of iNPH patients. Read More

Neuroimage Clin 2018 Nov 19. Epub 2018 Nov 19.

Department of Radiology, Mayo Clinic and Foundation, Rochester, MN, USA.

Objective: Create an automated classifier for imaging characteristics of disproportionately enlarged subarachnoid space hydrocephalus (DESH), a neuroimaging phenotype of idiopathic normal pressure hydrocephalus (iNPH).

Methods: 1597 patients from the Mayo Clinic Study of Aging (MCSA) were reviewed for imaging characteristics of DESH. One core feature of DESH, the presence of tightened sulci in the high-convexities (THC), was used as a surrogate for the presence of DESH as the expert clinician-defined criterion on which the classifier was trained. Read More

Int J Geriatr Psychiatry 2019 Mar 21;34(3):453-462. Epub 2018 Dec 21.

Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan.

Objectives: Apathy is prevalent in patients with idiopathic normal pressure hydrocephalus (iNPH), a treatable disorder resulting from ventricular enlargement. We assessed the relationship between apathy and regional cerebral blood flow (rCBF) in patients with iNPH.

Methods: Before lumbo-peritoneal shunt surgery (LPS), 56 iNPH patients were evaluated on apathy and dysphoria subscales of the Neuropsychiatric inventory (NPI), and were divided into two groups according to NPI apathy score: 15 without apathy (iNPH-APA) and 41 with apathy (iNPH+APA). Read More

AJNR Am J Neuroradiol 2019 Jan 22;40(1):68-73. Epub 2018 Nov 22.

Biomedical Engineering (A.R.B.), University of New South Wales, Sydney, New South Wales, Australia.

Background And Purpose: Chronic hydrocephalus is associated with dilated ventricles despite a normal intracranial pressure. In idiopathic intracranial hypertension, the ventricles are normal despite an elevated intracranial pressure. This apparent paradox has largely remained unexplained. Read More

J Neuroimaging 2018 Nov 20. Epub 2018 Nov 20.

Department of Neurology, McGovern Medical School, University of Texas Health Science Center (UTHSC), Houston, TX (KY, CEM, ZK, OH, PES).

Background And Purpose: Ventricular enlargement in elderly raises a challenging differential diagnosis to physicians. While Alzheimer's disease is the most common form of dementia, idiopathic normal pressure hydrocephalus (iNPH) constitutes a potentially reversible syndrome. iNPH has a unique pathophysiology pertaining to cerebrospinal fluid (CSF) dynamics and periventricular white matter. Read More

Acta Neurol Scand 2019 Mar 3;139(3):305-312. Epub 2018 Dec 3.

Department of Psychiatry, University of Cambridge, Cambridge, UK.

Objectives: The pathological bases for the cognitive and neuropsychiatric symptoms in normal pressure hydrocephalus (NPH) have not been elucidated. However, the symptoms may indicate dysfunction of subcortical regions. Previously, volume reductions of subcortical deep grey matter (SDGM) structures have been observed in NPH patients. Read More

AJNR Am J Neuroradiol 2018 Dec 1;39(12):2218-2223. Epub 2018 Nov 1.

Department of Neurology (J.G.), New York University School of Medicine, New York, New York.

Background And Purpose: Normal Pressure Hydrocephalus is a reversible form of dementia characterized by enlarged ventricles, which can deform and cause disruptions to adjacent white matter fibers. The purpose of this work was to examine how diffusion and kurtosis parameters vary along the corticospinal tract and determine where along this path microstructure is compromised in patients diagnosed with normal pressure hydrocephalus. We hypothesized that disruption of the corticospinal tract from ventricular enlargement can be measured using diffusion MR imaging and this will be quantified in periventricular regions. Read More

Lancet Neurol 2018 Nov;17(11):1016-1024

Centre for Translational Neuromedicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Center for Translational Neuromedicine, Department of Neurosurgery, University of Rochester Medical Center, Rochester, NY, USA; Department of Neuroscience, University of Rochester Medical Center, Rochester, NY, USA. Electronic address:

Background: The glymphatic (glial-lymphatic) pathway is a fluid-clearance pathway identified in the rodent brain in 2012. This pathway subserves the flow of CSF into the brain along arterial perivascular spaces and subsequently into the brain interstitium, facilitated by aquaporin 4 (AQP4) water channels. The pathway then directs flow towards the venous perivascular and perineuronal spaces, ultimately clearing solutes from the neuropil into meningeal and cervical lymphatic drainage vessels. Read More

Trials 2018 Oct 17;19(1):566. Epub 2018 Oct 17.

Centre for Clinical Research, Unfallkrankenhaus Berlin, Warener Str. 7, 12683, Berlin, Germany.

Background: Idiopathic normal-pressure hydrocephalus (iNPH) is a distinct form of dementia, characterized by gait ataxia, cognitive impairment and urinary incontinence. In contrast to all other causes of dementia (e.g. Read More

Glia 2019 01 10;67(1):91-100. Epub 2018 Oct 10.

Department of Neurosurgery, Oslo University Hospital - Rikshospitalet, Oslo, Norway.

Idiopathic normal pressure hydrocephalus (iNPH) is a subtype of dementia that may be successfully treated with cerebrospinal fluid (CSF) diversion. Recently, magnetic resonance imaging (MRI) using a MRI contrast agent as a CSF tracer revealed impaired clearance of the CSF tracer from various brain regions such as the entorhinal cortex of iNPH patients. Hampered clearance of waste solutes, for example, soluble amyloid-β, may underlie neurodegeneration and dementia in iNPH. Read More

Neuroradiology 2019 Jan 30;61(1):37-42. Epub 2018 Sep 30.

Department of Neurosurgery, Tama-Hokubu Medical Center, Health and Medical Treatment Corporation, Higashimurayamashi, Tokyo, Japan.

Purpose: The purpose of this study was to elucidate the specific regional cerebral blood flow (rCBF) alterations for idiopathic normal pressure hydrocephalus (iNPH) by comparing the proportional rCBF and gray matter change from those of a normal database at the same point of SPECT and MRI examinations.

Methods: Thirty subjects with iNPH underwent both CBF SPECT and MRI. After normalization, voxel-wise two-sample t tests between patients and 11 normal controls were conducted to compare the regional alteration in the gray matter density and rCBF. Read More

Neuroimage Clin 2018 14;20:731-741. Epub 2018 Sep 14.

Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Neurosurgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway. Electronic address:

The aim of the present study was to examine cerebrospinal fluid (CSF) volumetric net flow rate and direction at the cranio-cervical junction (CCJ) and cerebral aqueduct in individuals with idiopathic normal pressure hydrocephalus (iNPH) using cardiac-gated phase-contrast magnetic resonance imaging (PC-MRI). An in-depth, pixel-by-pixel analysis of regions of interest from the CCJ and cerebral aqueduct, respectively, was done in 26 iNPH individuals, and in 4 healthy subjects for validation purposes. Results from patients were compared with over-night measurements of static and pulsatile intracranial pressure (ICP). Read More

Neurol India 2018 Sep-Oct;66(5):1407-1412

Department of Radiology and Imaging Sciences, Malabar Institute of Medical Sciences, Calicut, Kerala, India.

Objectives: To compare the change in peak cerebrospinal (CSF) flow velocity at the cerebral aqueduct in patients with normal pressure hydrocephalus (NPH) before and after CSF tapping with clinical outcome of the patients, i.e., gait improvement. Read More

World Neurosurg 2018 Dec 11;120:e1120-e1127. Epub 2018 Sep 11.

Department of Neurosurgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA; Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia. Electronic address:

Introduction: The pathophysiology of normal-pressure hydrocephalus and the correlation with its symptomatology is not well understood.

Objective: To monitor and evaluate the enlargement patterns of the ventricular system for each ventricle and its correlation with the presenting symptoms.

Methods: Bilateral kaolin injection into the subarachnoid space overlying the cranial convexities was done in 18 adult rats. Read More

Neurologist 2018 Sep;23(5):157-159

Neurology, AZ Maria Middelares.

Introduction: Wall-eyed bilateral internuclear ophthalmoplegia (WEBINO) is a variant syndrome of internuclear ophthalmoplegia, consisting of primary gaze exotropia, adduction impairment, nystagmus of the abducting eye, and vertical gaze-evoked nystagmus. It seems to be most frequently associated with multiple sclerosis, although other etiologies such as brainstem ischemia or hydrocephalus have also been described.

Case Report: We report the case of a 25-year-old woman who presented with subacute progressive oculomotor disturbances, resulting in the development of a WEBINO over a few days. Read More

J Neurol 2018 Oct 28;265(10):2434-2441. Epub 2018 Aug 28.

Division of Neurology, Department of Clinical Neurosciences, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.

Objective: Idiopathic normal pressure hydrocephalus (iNPH) and iNPH mimics (i.e., Parkinson's disease, progressive supranuclear palsy or dementia with Lewy bodies) share similar clinical features, and discrimination between both conditions relies on invasive time-consuming investigations. Read More

J Neurol Sci 2018 Oct 6;393:105-109. Epub 2018 Aug 6.

Department of Neurological Surgery, University of Miami Miller School of Medicine, 1095 NW 14(th) Terrace (D4-6), Miami, FL 33136, United States.

Normal pressure hydrocephalus (NPH) is generally treated with ventriculoperitoneal shunts (VPS), with improved symptoms in the majority of patients. We performed a retrospective chart review study in order to describe patterns of, and risk factors for, delayed symptom progression after initially successful VPS placement. 69 consecutive patients underwent VPS placement for NPH, and were followed for a minimum of 12 months postoperatively. Read More

Zhonghua Yi Xue Za Zhi 2018 Aug;98(31):2485-2488

The Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.

To investigate the effect of Ventriculoperitoneal shunt (VPS)in adult patients with idiopathic normal pressure hydrocephalus (iNPH). The patients with idiopathic normal pressure hydrocephalus were reviewed, who were admitted into the Peking union medical college hospital from October 2010 to October 2016.The patients treated via VPS were retrospectively analyzed by collecting the data including clinic features, iNPH score and imaging data. Read More

JCI Insight 2018 Jul 12;3(13). Epub 2018 Jul 12.

Institute of Clinical Medicine, Faculty of Medicine, and.

To what extent does the subarachnoid cerebrospinal fluid (CSF) compartment communicate directly with the extravascular compartment of human brain tissue? Interconnection between the subarachnoid CSF compartment and brain perivascular spaces is reported in some animal studies, but with controversy, and in vivo CSF tracer studies in humans are lacking. In the present work, we examined the distribution of a CSF tracer in the human brain by MRI over a prolonged time span. For this, we included a reference cohort, representing close to healthy individuals, and a cohort of patients with dementia and anticipated compromise of CSF circulation (idiopathic normal pressure hydrocephalus). Read More

Audiol Res 2018 Mar 6;8(1):200. Epub 2018 Jun 6.

Department of Applied Clinical Sciences and Biotechnology, L'Aquila University, L'Aquila.

We report a case of a 54-year old female patient, complaining for chronic dizziness, hearing loss, tension headaches without aura, postural instability and gait dysfunction. The patient referred having these symptoms from 1992, but the last few months she experienced a noticeable aggravation of the symptoms. A magnetic resonance imaging test revealed a triventricular hydrocephalus, not associated with signs of intracranial hypertension decompensation. Read More

World Neurosurg 2018 Nov 4;119:e46-e52. Epub 2018 Jul 4.

Department of Radiology & Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut, USA; Department of Neurosurgery, Yale School of Medicine, New Haven, Connecticut, USA. Electronic address:

Objective: The counseling of patients with idiopathic normal pressure hydrocephalus (iNPH) is difficult; there is variability in the diagnostic criteria, and a definitive diagnosis can be made only postoperatively. A patient's clinical response to shunting is also difficult to predict. This study examines the subjective experience of patients treated for iNPH, to identify the challenges patients face and to improve patient outcomes and satisfaction. Read More

Front Neurol 2018 15;9:411. Epub 2018 Jun 15.

Section of Neurosciences, Department "G.F. Ingrassia", University of Catania, Catania, Italy.

PLoS One 2018 19;13(6):e0198752. Epub 2018 Jun 19.

Department of Neurosurgery, University Hospital of Basel, Basel, Switzerland.

Despite being widely used, ventriculoperitoneal (VP) shunt placement is a procedure often associated with complications and revision surgeries. Many neurosurgical centers routinely perform early postoperative cranial computer tomography (CT) to detect postoperative complications (e.g. Read More

Neuroimage Clin 2018 28;18:897-902. Epub 2018 Feb 28.

Department of Neurology Mayo Clinic, Rochester, MN 55901, USA.

Background: Idiopathic normal pressure hydrocephalus (iNPH) is an important and treatable cause of neurologic impairment. Diagnosis is complicated due to symptoms overlapping with other age related disorders. The pathophysiology underlying iNPH is not well understood. Read More

J Alzheimers Dis 2018 ;64(1):171-179

Turku PET Centre, University of Turku, Turku, Finland.

Background: Detection of pathological tau aggregates could facilitate clinical diagnosis of Alzheimer's disease (AD) and monitor drug effects in clinical trials. S-[18F]THK-5117 could be a potential tracer to detect pathological tau deposits in brain. However, no previous study have correlated S-[18F]THK-5117 uptake in PET with brain biopsy verified tau pathology in vivo. Read More

World Neurosurg 2018 Aug 1;116:e1075-e1078. Epub 2018 Jun 1.

Department of Neurosurgery Barrow Neurological Institute St. Joseph's Hospital and Medical Center Phoenix, Arizona, USA. Electronic address:

Objective: The Barrow Innovation Center consists of an educational program that promotes interdisciplinary collaboration among neurosurgery, legal, and engineering professionals to foster the development of new medical devices. This report describes a common issue faced during the placement of ventricular shunts for the treatment of hydrocephalus and the solution to this problem that was developed through the Barrow Innovation Center.

Methods: Neurosurgery residents involved in the Barrow Innovation Center presented the problem of ferromagnetic retractors interfering with pinless image-guidance systems at a monthly meeting. Read More

Mol Neurobiol 2018 May 26. Epub 2018 May 26.

Department of Urology, Maastricht University Medical Center, Maastricht, The Netherlands.

The periaqueductal gray matter (PAG), as one of the mostly preserved evolutionary components of the brain, is an axial structure modulating various important functions of the organism, including autonomic, behavioral, pain, and micturition control. It has a critical role in urinary bladder physiology, with respect to storage and voiding of urine. The PAG has a columnar composition and has extensive connections with its cranially and caudally located components of the central nervous system (CNS). Read More

World Neurosurg 2018 Aug 24;116:174-177. Epub 2018 May 24.

Department of Neurosurgery, Sint-Jan Hospital Brugge, University Hospitals Leuven, Brugge, Belgium.

Background: Pneumocephalus is usually seen in trauma or cranial surgery. It is rarely reported as a delayed complication of ventriculoperitoneal shunt placement for hydrocephalus secondary to trauma, tumor, or aqueduct stenosis. We describe a case of intraventricular pneumocephalus manifesting 10 months after placement of a shunt for normal-pressure hydrocephalus. Read More

Neurol Sci 2018 09 24;39(9):1643-1646. Epub 2018 May 24.

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

J Clin Endocrinol Metab 2018 07;103(7):2424-2429

Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.

Context: The persisting embryonal infundibular recess (PEIR) is a rare anomaly of the floor of the third ventricle with a debated pathogenesis. It can be a cause of misdiagnosis in the case of cystic lesions of the sellar and suprasellar area.

Objective: To describe two recently evaluated cases and provide a systematic literature review. Read More

Neurosurgery 2018 May 8. Epub 2018 May 8.

Neurosurgery of NeuroCenter, Kuopio University Hospital (KUH) and University of Eastern Finland (UEF), Kuopio, Finland.

Background: Idiopathic normal pressure hydrocephalus (iNPH) is a progressive and potentially treatable neurodegenerative disease affecting elderly people, characterized by gait impairment and ventricular enlargement in brain imaging. Similar findings are seen in some patients with schizophrenia (SCZ).

Objective: To determine the prevalence of SCZ among patients suffering from probable or possible iNPH and the specific effects of comorbid SCZ on the outcome of the cerebrospinal fluid (CSF) shunting. Read More

Eur Radiol 2018 May 7. Epub 2018 May 7.

Research Center of Translational Imaging, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.

Objectives: To compare diffusion tensor (DT)-derived indices from the thalamic nuclei and cerebrospinal fluid (CSF) hydrodynamic parameters for the prediction of gait responsiveness to the CSF tap test in early iNPH patients.

Methods: In this study, 22 patients with iNPH and 16 normal controls were enrolled with the approval of an institutional review board. DT imaging and phase-contrast magnetic resonance imaging were performed in patients and controls to determine DT-related indices of the sensorimotor-related thalamic nuclei and CSF hydrodynamics. Read More

World Neurosurg 2018 Jul 1;115:e717-e722. Epub 2018 May 1.

Department of Neurological Surgery, Loyola University School of Medicine, Maywood, Illinois, USA.

Background: Diagnosing normal-pressure hydrocephalus (NPH) and selecting patients who will experience a sustained benefit from fluid diversion surgery remains challenging. This study seeks to evaluate the association between the callosal angle (CA) and the long-term postoperative response to ventriculoperitoneal shunt surgery in a different subgroup population than previously studied to assess its generalizability.

Methods: We studied 72 patients with idiopathic NPH who underwent ventriculoperitoneal shunt surgery and had at least 18 months of follow-up between 2000 and 2016. Read More

PLoS One 2018 30;13(4):e0196216. Epub 2018 Apr 30.

Department of Biomedical Engineering, Islamic Azad University-Tehran North Branch, Tehran, Iran.

3D fluid-structure interaction modelling was utilized for simulation of 13 normal subjects, 11 non-communicating hydrocephalus (NCH) patients at pre-treatment phase, and 3 patients at five post-treatment phases. Evaluation of ventricles volume and maximum CSF pressure (before shunting) following results validation indicated that these parameters were the most proper hydrodynamic indices and the NCH type doesn't have any significant effect on changes in two indices. The results confirmed an appropriate correlation between these indices although the correlation decreased slightly after the occurrence of disease. Read More

Radiol Phys Technol 2018 Jun 26;11(2):219-227. Epub 2018 Apr 26.

Graduate School of Nursing, Hyogo University of Health Sciences, 1-3-6, Minatojima, Chuo-ku, Kobe, Hyogo, 650-8530, Japan.

This study aimed to evaluate the effect of ventricular enlargement on the specific binding ratio (SBR) and to validate the cerebrospinal fluid (CSF)-Mask algorithm for quantitative SBR assessment of I-FP-CIT single-photon emission computed tomography (SPECT) images with the use of a 3D-striatum digital brain (SDB) phantom. Ventricular enlargement was simulated by three-dimensional extensions in a 3D-SDB phantom comprising segments representing the striatum, ventricle, brain parenchyma, and skull bone. The Evans Index (EI) was measured in 3D-SDB phantom images of an enlarged ventricle. Read More

J Integr Neurosci 2018 Apr 18. Epub 2018 Apr 18.

Laboratory of Medical Physics, Medical School, Democritus University of Thrace, Alexandroupolis, 68100, Greece.

A 82-year-old male experiencing headaches, dementia, urinary incontinence and gait instability was diagnosed with normal pressure hydrocephalus (NPH) and underwent a resting state magnetoencephalography (MEG) examination. MEG data were recorded in a magnetically shielded room with a whole-head 122 channel biomagnetometer. Following MEG, a ventriculoperitoneal (VP) shunt was placed in his head and greatly improved his symptomatology. Read More

Cureus 2018 Feb 19;10(2):e2205. Epub 2018 Feb 19.

Neurosurgery, Inova Fairfax.

Objective Ventricular shunts are a mainstay of hydrocephalus treatment, but the detection of its clinical failure often relies on circumstantial evidence. A direct, non-interventional method for reliably evaluating cerebrospinal fluid (CSF) function does not exist due to the difficulty of measuring in vivo flow characteristics. The objective of this study is to apply a novel method of ultrasound monitoring to characterize the oscillation observed during pulsatile CSF flow and failure states in an in vitro and cadaveric model. Read More

Eur Neurol 2018 22;79(3-4):192-199. Epub 2018 Mar 22.

Department of Neurology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.

Background: The first aim of our study was to determine whether cortical 18F-florbetaben retention was different between healthy controls and idiopathic normal-pressure hydrocephalus (INPH) patients. Our second aim was to investigate whether there were any relationships between 18F-florbetaben retention and either hippocampal volume or clinical symptoms in INPH patients.

Methods: Seventeen patients diagnosed with INPH and 8 healthy controls underwent studies with magnetic resonance imaging and 18F-florbetaben positron emission tomography imaging. Read More

World Neurosurg 2018 Jun 16;114:348-351. Epub 2018 Mar 16.

Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA. Electronic address:

Background: Ventriculoatrial shunts are common alternatives for patients who cannot tolerate ventriculoperitoneal shunts. The majority of ventriculoatrial shunt malfunctions are related to mechanical problems. We report an interesting case of ventriculoatrial shunt malfunction due to elevated central venous pressure from new-onset atrial fibrillation. Read More

J Neurosurg 2018 Mar 1:1-9. Epub 2018 Mar 1.

OBJECTIVEThe aim of this study was to provide a comprehensive benchmark of 30-day ventriculoperitoneal (VP) shunt failure rates for a single institution over a 5-year study period for both adult and pediatric patients, to compare this with the results in previously published literature, and to establish factors associated with shunt failure.METHODSA retrospective database search was undertaken to identify all VP shunt operations performed in a single, regional neurosurgical unit during a 5-year period. Data were collected regarding patient age, sex, origin of hydrocephalus, and whether the shunt was a primary or secondary shunt. Read More