Difference between revisions of "CT of hydrocephalus"

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===Causes===
 
===Causes===
 
Attempt to indicate either of the main causes: Normal pressure hydrocephalus (NPH) versus cerebral atrophy (as part of [[CT in dementia]]):
 
Attempt to indicate either of the main causes: Normal pressure hydrocephalus (NPH) versus cerebral atrophy (as part of [[CT in dementia]]):
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|+Typical imaging findings in normal pressure hydrocephalus versus brain atrophy.<ref name="Damasceno2015">{{cite journal|last1=Damasceno|first1=Benito Pereira|title=Neuroimaging in normal pressure hydrocephalus|journal=Dementia & Neuropsychologia|volume=9|issue=4|year=2015|pages=350–355|issn=1980-5764|doi=10.1590/1980-57642015DN94000350}}</ref>
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File:Normal pressure hydrocephalus versus atrophy.jpg|Head CT in normal pressure hydrocephalus (left image) and head MRI (right image), in the coronal plane at the level of the posterior commissure. In the left image, the CSF spaces over the convexity near the vertex are narrowed ("tight convexity", red circle), as are the medial cisterns (red circle) - these are typical findings of NPH. On the right image, however, the CSF spaces over the convexity near the vertex (red arrow) and the medial cisterns (green arrow) are widened, a finding consistent with brain atrophy. <br>The blue lines in both images indicate the callosal angle: an acute angle is typical of NPH (left image), while an obtuse angle is typical of brain atrophy (right image). <br>The blue arrows indicate leucoaraiosis (periventricular signal alterations). In the left image these may well represent transependymal CSF diapedesis due to NPH. The unilateral occurrence of these alterations in right image suggests they are probably due to vascular encephalopathy.<ref name="Damasceno2015">{{cite journal|last1=Damasceno|first1=Benito Pereira|title=Neuroimaging in normal pressure hydrocephalus|journal=Dementia & Neuropsychologia|volume=9|issue=4|year=2015|pages=350–355|issn=1980-5764|doi=10.1590/1980-57642015DN94000350}}</ref>
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File:Normal pressure hydrocephalus versus atrophy.jpg
 
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! Normal pressure hydrocephalus !! Brain atrophy
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| Preferable projection ||colspan=2| Coronal plane at the level of the posterior commissure of the brain.
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| Modality in this example || [[CT]] || [[MRI]]
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| CSF spaces over the convexity near the vertex (red ellipse [[File:Red ellipse.png|20px]]) || Narrowed convexity ("tight convexity") as well as medial cisterns || Widened vertex (red arrow) and medial cisterns (green arrow)
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| Callosal angle (blue <font color="DodgerBlue">'''V'''</font>) || Acute angle || Obtuse angle is typical of brain atrophy
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| Most likely cause of leucoaraiosis (periventricular signal alterations, blue arrows [[File:Flecha tesela.svg|25px]])
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| Transependymal cerebrospinal fluid diapedesis
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| Vascular encephalopathy, in this case suggested by unilateral occurrence
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{{Bottom}}

Latest revision as of 13:28, 7 March 2019

Author: Mikael Häggström [notes 1]

Contents

Evaluation

Diagnosis

 
Evan's index

Evan's index is the ratio of maximum width of the frontal horns to the maximum width of the inner table of the cranium. An Evan's index more than 0.31 indicates hydrocephalus.[1]

Causes

Attempt to indicate either of the main causes: Normal pressure hydrocephalus (NPH) versus cerebral atrophy (as part of CT in dementia):

Typical imaging findings in normal pressure hydrocephalus versus brain atrophy.[2]
Normal pressure hydrocephalus Brain atrophy
Preferable projection Coronal plane at the level of the posterior commissure of the brain.
Modality in this example CT MRI
CSF spaces over the convexity near the vertex (red ellipse  ) Narrowed convexity ("tight convexity") as well as medial cisterns Widened vertex (red arrow) and medial cisterns (green arrow)
Callosal angle (blue V) Acute angle Obtuse angle is typical of brain atrophy
Most likely cause of leucoaraiosis (periventricular signal alterations, blue arrows  ) Transependymal cerebrospinal fluid diapedesis Vascular encephalopathy, in this case suggested by unilateral occurrence

Notes

  1. ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Radlines:Authorship for details.

References

  1. ↑ Ishii, Mitsuaki; Kawamata, Toshio; Akiguchi, Ichiro; Yagi, Hideo; Watanabe, Yuko; Watanabe, Toshiyuki; Mashimo, Hideaki (2010). "Parkinsonian Symptomatology May Correlate with CT Findings before and after Shunting in Idiopathic Normal Pressure Hydrocephalus ". Parkinson's Disease 2010: 1–7. doi:10.4061/2010/201089. ISSN 2042-0080. 
  2. ↑ Damasceno, Benito Pereira (2015). "Neuroimaging in normal pressure hydrocephalus ". Dementia & Neuropsychologia 9 (4): 350–355. doi:10.1590/1980-57642015DN94000350. ISSN 1980-5764. 
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