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Imaging of NPH

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Normal Pressure Hydrocephalus

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Abstract

Since the discovery of normal pressure hydrocephalus, scientists around the world have been trying to find a sufficiently accurate imaging biomarker that would identify shunt-responsive patients. Unlike functional tests, which currently play a fundamental role, the role of imaging methods is only supportive. In its basic form, MRI is the modality of choice. It can detect ventriculomegaly well and at the same time exclude any other pathology. MRI also allows us to perform some measurements, which will be described in more detail in the relevant subsections. It is primarily callosal angle, dilated Sylvian fissures, tight high convexity and focal sulcal dilation. These findings, along with ventriculomegaly, form the basis of the DESH score. Another finding typical for NPH is cingulate sulcus sign. Further MRI examinations already require special sequences. In this chapter, we will describe individual methods, including our personal experience with them. These are volumetric studies, diffusion tensor imaging and the phase contrast method. We will also marginally mention the experimental imaging of the glymphatic pathway.

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Abbreviations

AdaBoost:

Adaptive Boosting

AD:

Alzheimer’s disease

AUC:

Area under the curve

CSF:

Cerebrospinal fluid

CT:

Computed tomography

DESH:

Disproportionately enlarged subarachnoid space hydrocephalus

DTI:

Diffusion tensor imaging

DWI:

Diffusion-weighted imaging

FA:

Fractional anisotropy

GaussNB:

Gaussian Naive Bayes

iNPH:

Idiopathic normal pressure hydrocephalus

MD:

Mean diffusivity

MRI:

Magnetic resonance imaging

NPH:

Normal pressure hydrocephalus

ROC:

Receiver operating characteristic

VP:

Vetriculo-peritoneal

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Funding

This chapter was supported by the Ministry of Health of the Czech Republic institutional grant no. NU23-04–00551.

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Authors and Affiliations

  1. Department of Neurosurgery, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic

    Aleš Vlasák, Adéla Bubeníková & Ondřej Bradáč

  2. Department of Neurosurgery and Neurooncology, 1st Faculty of Medicine, Charles University and Military University Hospital, Prague, Czech Republic

    Adéla Bubeníková & Ondřej Bradáč

  3. Department of Radiology, Military University Hospital, Prague, Czech Republic

    Vojtěch Sedlák

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  1. Aleš Vlasák
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  2. Vojtěch Sedlák
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  3. Adéla Bubeníková
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  4. Ondřej Bradáč
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Correspondence to Ondřej Bradáč .

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Editors and Affiliations

  1. Department of Neurosurgery, 2nd Medical School, Motol University Hospital, Charles University, Prague, Czech Republic

    Ondrej Bradac

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Vlasák, A., Sedlák, V., Bubeníková, A., Bradáč, O. (2023). Imaging of NPH. In: Bradac, O. (eds) Normal Pressure Hydrocephalus. Springer, Cham. https://doi.org/10.1007/978-3-031-36522-5_16

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