Summary
The diagnostic value of computed tomography (CT) and spinal infusion test (SIT) was investigated in 27 patients with normal pressure hydrocephalus (NPH) and 35 patients with cerebral atrophy. The most consistent CT finding of NPH was dilatation of the temporal horns, that of cerebral atrophy widening of the convexity sulci. However, 43% of patients with cerebral atrophy demonstrated no cortical atrophy. The SIT showed an excellent relation with isotope cisternography and continuous intracranial pressure recording. NPH and cerebral atrophy were correctly differentiated in 71% by CT and SIT. A normal SIT and a CT scan without the typical features of NPH exclude impairment of cerebrospinal fluid absorption. An abnormal SIT and a CT scan showing ventricular enlargement without dilatation of convexity sulci, require isotope cisternography and possibly intracranial pressure recording to determine the degree of the absorption deficit.
Zusammenfassung
Der diagnostische Wert von Computertomographie (CT) und Spinalen Infusions-Test (SIT) wurde bei 27 Patienten mit „Normal Pressure Hydrocephalus“ (NPH) und 35 Patienten mit zerebraler Atrophie untersucht. Der häufigste CT-Befund des NPH war Erweiterung der Temporalhörner und bei zerebraler Atrophie eine Erweiterung der Konvexitätssulci. Aber 43% der Patienten mit zerebraler Atrophie zeigte keine Rindenatrophie. Der SIT zeigte eine sehr gute Korrelation mit Isotopenzisternographie und kontinuierlicher intrakraniellen Druckmessung. NPH und zerebrale Atrophie wurden korrekt differenziert in 71% mittels CT und SIT. Ein normaler SIT und ein CT-Scan ohne die typischen Merkmale von NPH schließen Liquorrückresorptionsstörungen aus. Ein abnormer SIT und ein CT-Scan, der einen Hydrozephalus ohne Erweiterung der Konvexitätssulci zeigt, erfordern eine Isotopenzisternographie und eventuell intrakranielle Druckmessung zur Ermittlung des Grades der Liquorrückresorptionsstörung.
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Tans, J.T.J. Differentiation of normal pressure hydrocephalus and cerebral atrophy by computed tomography and spinal infusion test. J. Neurol. 222, 109–118 (1979). https://doi.org/10.1007/BF00313004
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DOI: https://doi.org/10.1007/BF00313004