Abstract
Introduction: The diagnosis and management of idiopathic normal pressure hydrocephalus (INPH) remains unclear despite the development of guidelines. In addition, the role of cerebrospinal fluid (CSF) aqueductal stroke volume (ASV) remains unspecified.
Objectives: The aim of this study was to compare the results of the tap test (TT) and ASV in patients with possible INPH.
Materials and Methods: Among 21 patients investigated with both TT and phase-contrast (PC) MRI, we identified two groups, with either (1) a positive TT (PTT) or (2) a negative one (NTT), and we compared their ASV as measured by PC-MRI. ASV cutoff value was set at 70 μL/cardiac cycle (mean value +2 standard deviations in age-matched healthy subjects).
Results: In the PTT group (n = 9), the mean ASV was 175 ± 71 μL. Among these patients, four were shunted, and improved after surgery. In the NTT group, two patients were finally diagnosed with aqueductal stenosis and excluded. Among the remaining patients (n = 10), the mean ASV was 96 ± 93 μL (p < 0.05). However, three of these patients presented with hyperdynamic ASV, and an associated neurodegenerative disorder was diagnosed. Two patients had ventriculoperitoneal shunting despite their NTT, and improved.
Discussion/Conclusions: In our patient population, the noninvasive measurement of hyperdynamic ASV correlated with PTT, suggesting PC-MRI could be utilized to select those patients who would benefit from shunting. ASV may therefore be an interesting supplemental diagnosis tool.
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References
Balédent O, Henry-Feugeas MC, Idy-Peretti I (2001) Cerebrospinal fluid dynamics and relation with blood flow: a magnetic resonance study with semiautomated cerebrospinal fluid segmentation. Invest Radiol 36(7):368–377
Bradley WG, Scalzo D, Queralt J, Nitz WN, Atkinson DJ, Wong P (1996) Normal-pressure hydrocephalus: evaluation with cerebrospinal fluid flow measurements at MR imaging. Radiology 198(2):523–529
Dixon GR, Friedman JA, Luetmer PH, Quast LM, McClelland RL, Petersen RC, Maher CO, Ebersold MJ (2002) Use of cerebrospinal fluid flow rates measured by phase-contrast MR to predict outcome of ventriculoperitoneal shunting for idiopathic normal-pressure hydrocephalus. Mayo Clin Proc 77(6):509–514
Luetmer PH, Huston J, Friedman JA, Dixon GR, Petersen RC, Jack CR, McClelland RL, Ebersold MJ (2002) Measurement of cerebrospinal fluid flow at the cerebral aqueduct by use of phase-contrast magnetic resonance imaging: technique validation and utility in diagnosing idiopathic normal pressure hydrocephalus. Neurosurgery 50(3):534–543
Marmarou A, Bergsneider M, Klinge P, Relkin N, Black PM (2005) The value of supplemental prognostic tests for the preoperative assessment of idiopathic normal-pressure hydrocephalus. Neurosurgery 57(3 Suppl):S17–S28
Stivaros SM, Jackson A (2007) Changing concepts of cerebrospinal fluid hydrodynamics: role of phase-contrast magnetic resonance imaging and implications for cerebral microvascular disease. Neurotherapeutics 4(3):511–522
Stoquart-ElSankari S, Balédent O, Gondry-Jouet C, Makki M, Godefroy O, Meyer ME (2007) Aging effects on cerebral blood and cerebrospinal fluid flows. J Cereb Blood Flow Metab 27(9):1563–1572
Tullberg M, Hultin L, Ekholm S, Mansson JE, Fredman P, Wikkelso C (2002) White matter changes in normal pressure hydrocephalus and Binswanger disease: specificity, predictive value and correlations to axonal degeneration and demyelination. Acta Neurol Scand 105(6):417–426
Acknowledgments
This work was supported by European Community Grant Interreg (Inter-regional cooperation between University Hospital of Amiens and the University of Cambridge).
Conflicts of interest statement We declare that we have no conflict of interest.
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Sankari, S.E. et al. (2012). Correlation Between Tap Test and CSF Aqueductal Stroke Volume in Idiopathic Normal Pressure Hydrocephalus. In: Aygok, G., Rekate, H. (eds) Hydrocephalus. Acta Neurochirurgica Supplementum, vol 113. Springer, Vienna. https://doi.org/10.1007/978-3-7091-0923-6_9
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DOI: https://doi.org/10.1007/978-3-7091-0923-6_9
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