caa a22 4500 606215166 CHVBK 20210128101057.0 cr unu---uuuuu 210128e20151001xx s 000 0 eng 10.1007/s00701-015-2503-8 doi (NATIONALLICENCE)springer-10.1007/s00701-015-2503-8 Feasibility of radiological markers in idiopathic normal pressure hydrocephalus [Elektronische Daten] [Maria Kojoukhova, Anne Koivisto, Riika Korhonen, Anne Remes, Ritva Vanninen, Hilkka Soininen, Juha Jääskeläinen, Anna Sutela, Ville Leinonen] Background: Various radiological markers have been proposed for diagnostics in idiopathic normal pressure hydrocephalus (iNPH). We examined the usefulness of radiological markers in the diagnostics and prediction of shunt response in iNPH. Method: In this retrospective cohort study, we evaluated brain CT or MRI scans of 390 patients with suspected iNPH. Based on a 24-h intraventricular pressure monitoring session, patients were classified into a non-NPH (n = 161) or probable iNPH (n = 229) group. Volumes of cerebrospinal fluid compartments (lateral ventricles, sylvian and suprasylvian subarachnoid spaces and basal cisterns) were visually assessed. Disproportionally enlarged subarachnoid spaces, flow void, white matter changes, medial temporal lobe atrophy and focally dilated sulci were evaluated. Moreover, we measured quantitative markers: Evans' index (EI), the modified cella media index, mean width of the temporal horns and callosal angle. Results: iNPH was more likely in patients with severe volumetric disproportion between the suprasylvian and sylvian subarachnoid spaces than in those without disproportion (OR 7.5, CI 95% 4.0-14.1, P < 0.0001). Mild disproportion (OR 2.6, CI 95% 1.4-4.6, P = 0.001) and narrow temporal horns (OR per 1mm 0.91, CI 95% 0.84-0.98, P = 0.014) were also associated with an iNPH diagnosis. Other radiological markers had little association with the iNPH diagnosis in the final combined multivariate model. Interestingly, EI was higher in non-NPH than iNPH patients (0.40 vs. 0.38, P = 0.039). Preoperative radiological markers were not associated with shunt response. Conclusions: Visually evaluated disproportion was the most useful radiological marker in iNPH diagnostics. Narrower temporal horns also supported an iNPH diagnosis, possibly since atrophy was more pronounced in the non-NPH than iNPH group. Springer-Verlag Wien, 2015 Idiopathic normal pressure hydrocephalus nationallicence Radiology nationallicence Marker nationallicence Diagnosis nationallicence Shunt response nationallicence Disproportion nationallicence AD : Alzheimer's disease nationallicence CA : Callosal angle nationallicence CSF : Cerebrospinal fluid nationallicence CT : Computed tomography nationallicence EI : Evans' index nationallicence FDS : Focally dilated sulci nationallicence iNPH : Idiopathic normal pressure hydrocephalus nationallicence MRI : Magnetic resonance imaging nationallicence mCMI : Modified cella media index nationallicence NPH : Normal pressure hydrocephalus nationallicence SA : Subarachnoid nationallicence sNPH : Secondary normal pressure hydrocephalus nationallicence VD : Vascular dementia nationallicence Kojoukhova Maria Neurosurgery of NeuroCenter, Kuopio University Hospital and University of Eastern Finland, P.O. Box 100, FIN-70029, Kuopio, Finland aut Koivisto Anne Unit of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland aut Korhonen Riika Neurosurgery of NeuroCenter, Kuopio University Hospital and University of Eastern Finland, P.O. Box 100, FIN-70029, Kuopio, Finland aut Remes Anne Unit of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland aut Vanninen Ritva Department of Radiology, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland aut Soininen Hilkka Unit of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland aut Jääskeläinen Juha Neurosurgery of NeuroCenter, Kuopio University Hospital and University of Eastern Finland, P.O. Box 100, FIN-70029, Kuopio, Finland aut Sutela Anna Department of Radiology, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland aut Leinonen Ville Neurosurgery of NeuroCenter, Kuopio University Hospital and University of Eastern Finland, P.O. Box 100, FIN-70029, Kuopio, Finland aut Acta Neurochirurgica Springer Vienna 157/10(2015-10-01), 1709-1719 0001-6268 157:10<1709 2015 157 701 https://doi.org/10.1007/s00701-015-2503-8 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00701-015-2503-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kojoukhova Maria Neurosurgery of NeuroCenter, Kuopio University Hospital and University of Eastern Finland, P.O. Box 100, FIN-70029, Kuopio, Finland aut NATIONALLICENCE 700 1- Koivisto Anne Unit of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland aut NATIONALLICENCE 700 1- Korhonen Riika Neurosurgery of NeuroCenter, Kuopio University Hospital and University of Eastern Finland, P.O. Box 100, FIN-70029, Kuopio, Finland aut NATIONALLICENCE 700 1- Remes Anne Unit of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland aut NATIONALLICENCE 700 1- Vanninen Ritva Department of Radiology, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland aut NATIONALLICENCE 700 1- Soininen Hilkka Unit of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland aut NATIONALLICENCE 700 1- Jääskeläinen Juha Neurosurgery of NeuroCenter, Kuopio University Hospital and University of Eastern Finland, P.O. Box 100, FIN-70029, Kuopio, Finland aut NATIONALLICENCE 700 1- Sutela Anna Department of Radiology, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland aut NATIONALLICENCE 700 1- Leinonen Ville Neurosurgery of NeuroCenter, Kuopio University Hospital and University of Eastern Finland, P.O. Box 100, FIN-70029, Kuopio, Finland aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer Vienna 157/10(2015-10-01), 1709-1719 0001-6268 157:10<1709 2015 157 701