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Imaging Differential Diagnosis of Adult-Onset Hydrocephalus

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Normal Pressure Hydrocephalus

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Abstract

As clinical presentation of adult-onset hydrocephalus varies, imaging modalities often provide the first evidence of its presence. Features of increased intraventricular pressure can be subtle, especially early on in the disease course, and knowledge of radiologically relevant anatomy is important. When the presence of hydrocephalus is established, the next step is to determine its aetiology. This includes the assessment of which parts of the CSF spaces are involved, whether there is an obstruction and where it is located, if there are other signs of altered CSF hydrodynamics, or if there are secondary complications related to hydrocephalus. For optimal evaluation of hydrocephalus, a standardised protocol including flow-sensitive and high-resolution imaging should be employed.

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Notes

  1. 1.

    A phenomenon of flow-related signal loss in MRI due to time-of-flight and spin-phase effects. While disliked by some authors, the term “flow-voids” is in widespread clinical use and for the sake of conciseness, we will use the term in this book as well.

  2. 2.

    As opposed to cartesian readout, employed in the standard T2 FSE/TSE sequences.

  3. 3.

    Defined as head circumference above 98th percentile adjusted for sex [27]. For males, this is 53.8 cm and for females 52.9 cm.

Abbreviations

BRAVO:

Brain Volume Imaging

bSSFP:

Balanced steady-state free precession

CISS:

Constructive Interference in the Steady State

CSF:

Cerebrospinal fluid

CT:

Computed tomography

DESH:

Disproportionately Enlarged Subarachnoid space Hydrocephalus

DWI:

Diffusion-weighted imaging

EDH:

Epidural hematoma

ETL:

Echo train length

FIESTA:

Fast Imaging Employing Steady State Acquisition

FIESTA-C:

Fast Imaging Employing Steady State Acquisition-Constructive Interference

FLAIR:

Fluid attenuated inversion recovery

FSE:

Fast spin echo

iNPH:

Idiopathic Normal Pressure Hydrocephalus

LIAS:

Late-onset idiopathic aqueductal stenosis

LOVA:

Long-standing Overt Ventriculomegaly in Adults

MPR:

MultiPlanar Reconstruction

MPRAGE:

Magnetization Prepared RApid Gradient Echo

MR:

Magnetic Resonance

MRI:

Magnetic Resonance Imaging

PC:

Phase Contrast

PROPELLER:

Periodically Rotated Overlapping ParallEL Lines with Enhanced Reconstruction

ROI:

Region of Interest

SDH:

Subdural hematoma

SNR:

Signal to noise ratio

SPACE:

Sampling Perfection with Application optimized Contrasts using different flip angle Evolution

SSFP:

Steady-state free precession

SWI:

Susceptibility weighted imaging

TE:

Echo time

TSE:

Turbo spin echo

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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 Radiology, Military University Hospital, Prague, Czech Republic

    Vojtěch Sedlák

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

    Aleš Vlasák, Petr Skalický, Adéla Bubeníková & Ondřej Bradáč

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

    Adéla Bubeníková & Ondřej Bradáč

Authors
  1. Vojtěch Sedlák
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Correspondence to Ondřej Bradáč .

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

    Ondrej Bradac

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Sedlák, V., Vlasák, A., Skalický, P., Bubeníková, A., Bradáč, O. (2023). Imaging Differential Diagnosis of Adult-Onset Hydrocephalus. In: Bradac, O. (eds) Normal Pressure Hydrocephalus. Springer, Cham. https://doi.org/10.1007/978-3-031-36522-5_17

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  • DOI: https://doi.org/10.1007/978-3-031-36522-5_17

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