Introduction: The pathophysiology, diagnosis, and management of idiopathic normal pressure hydrocephalus (iNPH) remain unclear. Although some prognostic tests recommended in iNPH guidelines should have high sensitivity and high predictive value, there is often no positive clinical response to surgical treatment.
Materials And Methods: In our study, 19 patients with clinical and neuroradiological signs of iNPH were selected for preoperative evaluation and possible further surgical treatment according to the guidelines. MR volumetry of the intracranial and spinal space was performed. Patients were exposed to prolonged external lumbar drainage in excess of 10 ml per hour during 3 days. Clinical response to lumbar drainage was assessed by a walk test and a mini-mental test.
Results: Twelve of 19 patients showed a positive clinical response and underwent a shunting procedure. Volumetric values of intracranial space content in responders and non-responders showed no statistically significant difference. Total CSF volume (sum of cranial and spinal CSF volumes) was higher than previously published. No correlation was found between spinal canal length, CSF pressure, and CSF spinal volume. The results show that there is a significantly higher CSF volume in the spinal space in the responder group ( = 12) (120.5 ± 14.9 ml) compared with the non-responder group (103.1 ± 27.4 ml; = 7).
Discussion: This study demonstrates for the first time that CSF volume in the spinal space may have predictive value in the preoperative assessment of iNPH patients. The results suggest that patients with increased spinal CSF volume have decreased compliance. Additional prospective randomized clinical trials are needed to confirm our results.
Download full-text PDF |
Source |
---|---|
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10585139 | PMC |
http://dx.doi.org/10.3389/fneur.2023.1234396 | DOI Listing |
Neurosci Lett
January 2025
Max Super Speciality Hospital, Saket, New Delhi, India. Electronic address:
Background: Clinical brain MRI scans, including contrast-enhanced (CE-MR) images, represent an underutilized resource for neuroscience research due to technical heterogeneity.
Purpose: To evaluate the reliability of morphometric measurements from CE-MR scans compared to non-contrast MR (NC-MR) scans in normal individuals.
Methods: T1-weighted CE-MR and NC-MR scans from 59 normal participants (aged 21-73 years) were compared using CAT12 and SynthSeg + segmentation tools.
Cell
December 2024
Center for Translational Neuromedicine, University of Copenhagen, 2200 Copenhagen N, Denmark; Center for Translational Neuromedicine, University of Rochester, Rochester, NY 14627, USA. Electronic address:
As the brain transitions from wakefulness to sleep, processing of external information diminishes while restorative processes, such as glymphatic removal of waste products, are activated. Yet, it is not known what drives brain clearance during sleep. We here employed an array of technologies and identified tightly synchronized oscillations in norepinephrine, cerebral blood volume, and cerebrospinal fluid (CSF) as the strongest predictors of glymphatic clearance during NREM sleep.
View Article and Find Full Text PDFJ Med Imaging Radiat Oncol
January 2025
Department of Pediatric, Royal Children's Hospital, Melbourne, Victoria, Australia.
A prominent subarachnoid space (SAS) in infants under 24 months is a very common finding and is a normal variant that can be associated with macrocephaly. This must be differentiated from various pathological conditions that also cause a prominent SAS, including a reduction in brain volume, obstruction to the cerebrospinal fluid (CSF) or malformations of the skull. The inappropriate labelling of normal SAS prominence as enlargement due to pathology and misrepresentation of published literature by some author groups has created confusion medicolegally, contributing to inappropriate conclusions that a normal prominent SAS may cause subdural haemorrhage (SDH) and brain injury.
View Article and Find Full Text PDFNeuro Oncol
December 2024
Department of Neurological Surgery, Mayo Clinic, Rochester, MN, USA.
Cerebrospinal fluid (CSF) has emerged as a valuable liquid biopsy source for glioma biomarker discovery and validation. CSF produced within the ventricles circulates through the subarachnoid space, where the composition of glioma-derived analytes is influenced by the proximity and anatomical location of sampling relative to tumor, in addition to underlying tumor biology. The substantial gradients observed between lumbar and intracranial CSF compartments for tumor-derived analytes underscore the importance of sampling site selection.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
Turner Institute for Brain and Mental Health & School of Psychological Sciences, Monash University, Clayton, VIC, Australia.
Background: Plasma and cerebrospinal (CSF) biomarkers are promising candidates for detecting neuropathology. While CSF biomarkers directly reflect pathophysiological processes within the central nervous system, their requirement for a lumbar puncture is a barrier to their widespread scalability in practice. Therefore, we examined cross-sectional associations of plasma biomarkers of amyloid (Aβ42/Aβ40 and pTau-181), neurodegeneration (Neurofilament Light, NfL), and neuroinflammation (Glial Fibrillary Acidic Protein, GFAP) with brain volume, cognition, and their corresponding CSF levels.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!