Neurosurgical Review

, Volume 38, Issue 2, pp 239–244 | Cite as

DTI-MRI biomarkers in the search for normal pressure hydrocephalus aetiology: a review

  • David Hoza
  • Aleš Vlasák
  • Daniel Hořínek
  • Martin Sameš
  • Alex Alfieri
Review

Abstract

Normal pressure hydrocephalus (NPH) is a clinical syndrome characterized by gait disturbances, urinary incontinence and dementia. Clinical presentation overlaps with Alzheimer disease (AD). Early recognition thus early intervention (shunting) is important for successful treatment, but lack of a diagnostic test with sufficient sensitivity and specificity complicates the diagnosis. We performed literature search and composed a structured review of imaging biomarkers of NPH. Morphometric studies are not sufficient to diagnose NPH. Hydrocephalus is a common finding in elderly people due to the symmetric brain atrophy and is even more pronounced in patients with AD. The key MRI biomarker seems to be diffusion tensor imaging (DTI). According to recent studies, the DTI analysis of the splenium corporis callosi, posterior limb of internal capsule, hippocampus and fornix combined with measurement of Evans index is a promising MRI biomarker of NPH and could be used for NPH diagnostics and in the differential diagnosis from AD and other dementias.

Keywords

Normal pressure hydrocephalus Diffusion tensor imaging MRI biomarkers Ventriculomegaly 

Notes

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • David Hoza
    • 1
  • Aleš Vlasák
    • 2
  • Daniel Hořínek
    • 3
  • Martin Sameš
    • 3
  • Alex Alfieri
    • 4
  1. 1.Department of NeurosurgeryHospital DessauDessau-RoßlauGermany
  2. 2.Department of NeurosurgeryUniversity Hospital MotolPragueCzech Republic
  3. 3.Department of NeurosurgeryHospital Ústí nad LabemÚstí nad LabemCzech Republic
  4. 4.Department of NeurosurgeryRuppiner Kliniken GmbHNeuruppinGermany

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