Radiographic Evaluation of Normal Pressure Hydrocephalus.

Q1 Medicine

CONTINUUM Lifelong Learning in Neurology Pub Date : 2025-06-01 DOI:10.1212/CON.0000000000001577

Petrice Cogswell, Aaron Switzer

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引用次数: 0

Abstract

Objective: Normal pressure hydrocephalus (NPH) is a clinical syndrome of a gait disorder, cognitive impairment, and urinary incontinence that also has characteristic imaging features. This article provides an overview of the radiographic evaluation and imaging features of NPH.

Latest developments: Ventriculomegaly is an overarching imaging feature of NPH, although it is nonspecific. More specific imaging features have been described in association with NPH subtypes. Patients with idiopathic NPH commonly have features of ventriculomegaly, high-convexity tight sulci, and enlarged sylvian fissures. Patients with delayed-onset congenital NPH have features of marked ventriculomegaly, without extraventricular hydrocephalus, and may have stenosis or obstruction of the cerebral aqueduct. Evaluation of CSF dynamics, patterns of radiotracer uptake on positron emission tomography (PET), and patterns of brain stiffness on MR elastography can help to differentiate idiopathic NPH from secondary NPH or a neurodegenerative process.

Essential points: Imaging features of disproportionately enlarged subarachnoid space hydrocephalus are important to recognize as they are part of the diagnostic criteria for idiopathic NPH and aid in differentiating NPH from a neurodegenerative process. Evaluation of CSF dynamics, patterns of fludeoxyglucose (FDG) uptake, and patterns of brain stiffness may aid in the evaluation of challenging cases that lack typical clinical and structural radiographic features.

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正常压力性脑积水的影像学评价。

目的：常压脑积水（NPH）是一种步态障碍、认知障碍和尿失禁的临床综合征，也具有特征性的影像学特征。本文综述了NPH的影像学评价和影像学特征。最新进展：脑室肿大是NPH的首要影像学特征，尽管它是非特异性的。已经描述了与NPH亚型相关的更具体的影像学特征。特发性NPH患者通常具有脑室肿大，高凸性紧密沟和脑室裂扩大的特征。迟发性先天性NPH患者有明显脑室肿大的特征，无脑室外脑积水，可能有脑导水管狭窄或梗阻。评估脑脊液动力学，正电子发射断层扫描（PET）的放射性示踪剂摄取模式，以及MR弹性成像的脑僵硬模式可以帮助区分特发性NPH与继发性NPH或神经退行性过程。要点：不成比例增大的蛛网膜下腔脑积水的影像学特征很重要，因为它们是特发性NPH诊断标准的一部分，有助于区分NPH与神经退行性疾病。评估脑脊液动力学、氟脱氧葡萄糖（FDG）摄取模式和脑僵硬模式可能有助于评估缺乏典型临床和结构放射学特征的挑战性病例。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

CONTINUUM Lifelong Learning in Neurology Medicine-Medicine (all)

CiteScore

5.80

自引率

0.00%

发文量

175

期刊介绍： Continue your professional development on your own schedule with Continuum: Lifelong Learning in Neurology®, the American Academy of Neurology" self-study continuing medical education publication. Six times a year you"ll learn from neurology"s experts in a convenient format for home or office. Each issue includes diagnostic and treatment outlines, clinical case studies, a topic-relevant ethics case, detailed patient management problem, and a multiple-choice self-assessment examination.