Focal dilation and paradoxical collapse of cortical fissures and sulci in patients with normal-pressure hydrocephalus

被引:38
作者
Holodny, AI
George, AE
De Leon, MJ
Golomb, J
Kalnin, AJ
Cooper, PR
机构
[1] Univ Med & Dent New Jersey, New Jersey Med Sch, Dept Radiol, Univ Hosp C 3200, Newark, NJ 07103 USA
[2] NYU Med Ctr, Dept Radiol, New York, NY 10016 USA
[3] NYU Med Ctr, Dept Psychiat, New York, NY 10016 USA
[4] NYU Med Ctr, Dept Neurol, New York, NY 10016 USA
[5] NYU Med Ctr, Dept Neurosurg, New York, NY 10016 USA
关键词
normal-pressure hydrocephalus; cerebral atrophy; ventriculoperitoneal shunt;
D O I
10.3171/jns.1998.89.5.0742
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Object. The authors describe a subgroup of patients with shunt-proven normal-pressure hydrocephalus (NPH) who presented with focal fissural and sulcal dilation on imaging studies. The specific radiological features and methods of differentiating this condition from cortical atrophy are delineated. Methods. Normal-pressure hydrocephalus has been described as dilation of the ventricles that is out of proportion to the sulci. Sulcal dilation has been taken as evidence of cortical atrophy and has even been used as a criterion to exclude patients from undergoing a shunting procedure. The authors describe five cases of patients with shunt-proven NPH who presented with focal dilation of cortical fissures and sulci. In three of the eases, there was a paradoxical decrease in the size of the dilated fissures and sulci that paralleled the decrease in the size of the lateral ventricles following successful shunting. Conclusions. This study demonstrates that focal fissural and sulcal dilation may represent reservoirs of cerebrospinal fluid analogous to the ventricular system. Patients should not be denied a shunting procedure solely on the basis of focally dilated fissures of sulci.
引用
收藏
页码:742 / 747
页数:6
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