Table of Contents

Idiopathic normal pressure hydrocephalus Imaging

CT and MRI

MRI is preferred over CT because it provides more information and does not involve ionizing radiation (X-rays). Features on CT 1) and MRI 2):

There remains a lack of consensus about the role of individual imaging modalities in characterizing specific features of the condition and predicting the success of CSF shunting. Variability of clinical presentation and imperfect responsiveness to shunting are obstacles to the application of novel imaging techniques. Few studies have sought to interpret imaging findings in the context of theories of NPH pathogenesis 3).

Although attempts at predictive methodology, such as highvelocity aqueductal flow rate measurement on MRI, have achieved widespread acceptance in clinical practice, there is no Class I evidence (only 1 Class II study and 2 Class III studies) available to support this 4).

MRI

see Idiopathic normal pressure hydrocephalus Magnetic resonance imaging

SPECT

see SPECT for idiopathic normal pressure hydrocephalus diagnosis

1)
Vassilouthis J. The Syndrome of Normal-Pressure Hydrocephalus. J Neurosurg. 1984; 61:501–509
2)
Jack CR, Mokri B, Laws ER, et al. MR Findings in Normal Pressure Hydrocephalus: Significance and Comparison with Other Forms of Dementia. J Comput Assist Tomogr. 1987; 11:923–931
3)
Keong NC, Pena A, Price SJ, Czosnyka M, Czosnyka Z, Pickard JD. Imaging normal pressure hydrocephalus: theories, techniques, and challenges. Neurosurg Focus. 2016 Sep;41(3):E11. doi: 10.3171/2016.7.FOCUS16194. PubMed PMID: 27581307.
4)
Halperin JJ, Kurlan R, Schwalb JM, Cusimano MD, Gronseth G, Gloss D: Practice guideline: Idiopathic normal pressure hydrocephalus: Response to shunting and predictors of response: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology 85:2063–2071, 2015