Intracranial cerebrospinal fluid measurement studies in suspected idiopathic normal pressure hydrocephalus, secondary normal pressure hydrocephalus, and brain atrophy
Intracranial cerebrospinal fluid measurement studies in suspected idiopathic normal pressure hydrocephalus, secondary normal pressure hydrocephalus, and brain atrophy
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DOI：
10.1136/jnnp.73.5.552
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发表时间：
2002-11-01
影响因子：
11
通讯作者：
Sato, K
中科院分区：
文献类型：
--
作者：
Tsunoda, A;Mitsuoka, H;Sato, K
目的：探讨临床诊断为特发性常压性脑积水(INPH)患者的脑脊液(CSF)分布情况。对照组包括17例继发性正常压力性脑积水(SNPH)患者、21例脑萎缩患者和18名健康志愿者。结果：脑室容积/脑室容积比值明显高于正常对照组(37.8%比15.6%，p<；0.0001)。脑萎缩组脑室血流量明显高于健康对照组(284.4 mlvs 194.7 mlp=0.0002)。INPH组ICV增加(281.2毫升，P=0.0002)，VV/ICV比值增加(38.0%，P<0.0001)。24例INPH患者中有15例接受了分流术，I-I改善，4例无改善。结论：INPH患者除脑积水外，还存在脑萎缩。这可能有助于解释在诊断中遇到的困难和INPH患者分流手术的不可预测的应答率。
Objective: To investigate intracranial cerebrospinal fluid (CSF) distribution in patients with a clinical diagnosis of idiopathic normal pressure hydrocephalus (INPH).Methods: 24 patients with a clinical diagnosis of INPH were studied. Control groups comprised 17 patients with secondary normal pressure hydrocephalus (SNPH), 21 patients with brain atrophy, and 18 healthy volunteers. Ventricular volume (VV) and intracranial CSF volume (ICV) were measured using a magnetic resonance based method and the VV/ICV ratio was calculated.Results: The SNPH group showed a marked increase in the VV/ICV ratio compared with the healthy volunteers (37.8% v 15.6%, p < 0.0001). The brain atrophy group showed a significant increase in ICV compared with the healthy volunteers (284.4 ml v 194.7 ml, p = 0.0002). The INPH group showed an increase in ICV (281.2 ml, p = 0.0002) and an increase in the VV/ICV ratio (38.0%, p < 0.0001). Fifteen of 24 INPH patients underwent shunting; I I improved and four did not.Conclusions: The results suggest that INPH patients have brain atrophy in addition to hydrocephalic features. This may help to explain the difficulties encountered in the diagnosis and the unpredictable response rate to shunt surgery in INPH patients.