TY - JOUR
T1 - Changes in the volumes of the brain and cerebrospinal fluid spaces after shunt surgery in idiopathic normal-pressure hydrocephalus
AU - Hiraoka, Kotaro
AU - Yamasaki, Hiroshi
AU - Takagi, Masahito
AU - Saito, Makoto
AU - Nishio, Yoshiyuki
AU - Iizuka, Osamu
AU - Kanno, Shigenori
AU - Kikuchi, Hirokazu
AU - Kondo, Takeo
AU - Mori, Etsuro
N1 - Funding Information:
This work was partly supported by a Research Grant from the Ministry of Health, Labour and Welfare of Japan (2008-Nanchi-17).
PY - 2010/9/15
Y1 - 2010/9/15
N2 - Objectives: To investigate volumetric changes of the brain and cerebrospinal fluid (CSF) spaces after shunt surgery in shunt-responsive idiopathic normal-pressure hydrocephalus (iNPH), and correlations between the changes and postoperative clinical improvements. Methods: Twenty-one patients with shunt-responsive iNPH were studied. Magnetic resonance imaging (MRI) of the brain was performed before and 1 year after surgery, and clinical symptoms were assessed by the iNPH Grading Scale, a validated assessment tool of the triad of iNPH, the Modified Rankin Scale, the Timed Up and Go Test, and neuropsychological tests including the Mini-Mental State Examination. The volumes of the left cerebral hemisphere, infratentorial brain, ventricles, and suprasylvian and infrasylvian subarachnoid CSF spaces were measured using an MRI-based volumetric technique. Results: The volumes of the cerebral hemisphere and infratentorial brain did not change significantly after shunt surgery (p = 0.231, 0.109, respectively). The volumes of the ventricles and infrasylvian subarachnoid CSF spaces were significantly decreased (p < 0.0001, < 0.05, respectively), with a mean change rate of -26.1% and -4.5%, respectively. The volumes of the suprasylvian subarachnoid CSF spaces increased significantly (p < 0.0001), with a mean change rate of 43.5%. The decrease in ventricular volumes was significantly correlated with clinical improvement.
AB - Objectives: To investigate volumetric changes of the brain and cerebrospinal fluid (CSF) spaces after shunt surgery in shunt-responsive idiopathic normal-pressure hydrocephalus (iNPH), and correlations between the changes and postoperative clinical improvements. Methods: Twenty-one patients with shunt-responsive iNPH were studied. Magnetic resonance imaging (MRI) of the brain was performed before and 1 year after surgery, and clinical symptoms were assessed by the iNPH Grading Scale, a validated assessment tool of the triad of iNPH, the Modified Rankin Scale, the Timed Up and Go Test, and neuropsychological tests including the Mini-Mental State Examination. The volumes of the left cerebral hemisphere, infratentorial brain, ventricles, and suprasylvian and infrasylvian subarachnoid CSF spaces were measured using an MRI-based volumetric technique. Results: The volumes of the cerebral hemisphere and infratentorial brain did not change significantly after shunt surgery (p = 0.231, 0.109, respectively). The volumes of the ventricles and infrasylvian subarachnoid CSF spaces were significantly decreased (p < 0.0001, < 0.05, respectively), with a mean change rate of -26.1% and -4.5%, respectively. The volumes of the suprasylvian subarachnoid CSF spaces increased significantly (p < 0.0001), with a mean change rate of 43.5%. The decrease in ventricular volumes was significantly correlated with clinical improvement.
KW - Cerebrospinal fluid shunt
KW - Idiopathic normal-pressure hydrocephalus
KW - Magnetic resonance imaging
KW - Volumetry
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U2 - 10.1016/j.jns.2010.06.021
DO - 10.1016/j.jns.2010.06.021
M3 - Article
C2 - 20663514
AN - SCOPUS:77956882079
VL - 296
SP - 7
EP - 12
JO - Journal of the Neurological Sciences
JF - Journal of the Neurological Sciences
SN - 0022-510X
IS - 1-2
ER -