1. Assessment of neurofluid dynamics in relation to clinical improvement after tap-test: pilot study.
- Author
-
Moyet J, Baledent O, Slovenski T, Todessayi P, Metanbou S, Deschasse G, Bloch F, and Capel C
- Subjects
- Humans, Pilot Projects, Female, Male, Aged, Aged, 80 and over, Prospective Studies, Subarachnoid Space diagnostic imaging, Spinal Puncture methods, Hydrocephalus, Normal Pressure physiopathology, Hydrocephalus, Normal Pressure diagnostic imaging, Hydrocephalus, Normal Pressure surgery, Magnetic Resonance Imaging methods
- Abstract
Purpose: Idiopathic Normal pressure hydrocephalus (iNPH) is an under-diagnosed in elderly patients but none of the diagnostic tests are currently sufficiently sensitive or specific. The objective of this study was to analyze the dynamics of neurofluids by PC-MRI in relation to clinical evolution as measured using the iNPH grading scale after tap-test., Method: We prospectively included patients with suspected iNPH. All these patients underwent PCMRI to assess craniospinal hemohydrodynamics with analysis of the stroke volume of the cephalospinal fluid (CSF) within the Sylvius' aqueduct, within the high cervical subarachnoid spaces and the arteriovenous stroke volume. By this means, we calculated a compliance index. Morphological analysis was carried out using the DESH score. The infusion test was measuring the resistance to CSF flow. We analysed all these parameters according to the clinical improvement of the patients., Results: 23 patients were included. Compliance index assessed by PC-MRI was significantly higher in the group of patients with improvement > 10% (p = 0.015)., Conclusions: Our study highlights the importance of investigating arteriovenous and CSF interactions in iNPH. This involves understanding the physiological and pathophysiological mechanisms related to the circulation of neurofluids. The analysis of the interactions of these neurofluids allows for a comprehensive understanding of the system., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)
- Published
- 2024
- Full Text
- View/download PDF