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Congress: ECR25
Poster Number: C-22355
Type: Poster: EPOS Radiologist (educational)
Authorblock: E. Díaz Gordo1, P. Oleaga Gómez1, M. Gonzalo Domínguez1, M. J. Gimeno Peribáñez2, D. Ibáñez Muñoz2, J. Ramón Y Cajal Calvo2, J. Raymúndez Valhondo2, L. Urgel Yagüe2, M. P. Guiral Foz2; 1Zamora/ES, 2Zaragoza/ES
Disclosures:
Enrique Díaz Gordo: Nothing to disclose
Paula Oleaga Gómez: Nothing to disclose
Miguel Gonzalo Domínguez: Nothing to disclose
Maria José Gimeno Peribáñez: Nothing to disclose
David Ibáñez Muñoz: Nothing to disclose
Juan Ramón Y Cajal Calvo: Nothing to disclose
Javier Raymúndez Valhondo: Nothing to disclose
Laura Urgel Yagüe: Nothing to disclose
María Pilar Guiral Foz: Nothing to disclose
Keywords: Neuroradiology brain, CT, MR, Education, Dementia
Learning objectives -To review the imaging findings of normal pressure hydrocephalus (NPH) using Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). -To introduce new diagnostic methods such as the anteroposterior diameter of the lateral ventricle index (ALVI) and analyze the usefulness of MRI sequences.
Read more Background Normal pressure hydrocephalus (NPH) is a neurodegenerative condition that eventually progresses to dementia but remains treatable and potentially reversible with ventriculoperitoneal shunt (VPS). Early and accurate diagnosis is essential for improving patient outcomes. Traditionally, NPH is characterized by the Hakim-Adams triad: gait disturbances, urinary incontinence and cognitive impairment (“wet, wacky and wobby”).  Its incidence increases with age, affecting over 1% of individuals over 60 and more than 3% of those above 65, though it remains significantly underdiagnosed.Classification of Hydrocephalus: hydrocephalus...
Read more Findings and procedure details In suspected cases of NPH:-Rule out obstructive hydrocephalus.-Assess patient history for previous cerebral hemorrhages, meningitis, encephalitis, tumors, surgeries, or any condition that may affect CSF absorption.Imaging Analysis:- CT scan: First-line imaging tool providing an initial diagnostic impression.- MRI: Superior for detecting morphological changes.Radiological findings: Imaging findings reflect the brain´s response to impaired CSF absorption:-Increased vascular pulsatility displaces neural tissue around blood vessels, particularly in the Sylvian fissures.-Ventriculomegaly occurs due to systolic pressure peaks, exerting force on the ventricular walls, especially...
Read more Conclusion  -NPH is a common, serious, and reversible condition in the elderly that can be effectively diagnosed using imaging studies.- MRI is superior to CT for characterizing NPH, as it allows the identification of specific imaging signs and indices.-Emerging indices, such as ALVI, may provide faster and more reproducible assessments compared to traditional measures like Evans' index, although these are not yet widely adopted.-Phase-contrast MRI sequences for assessing CSF flow are valuable for diagnosis, prognosis, and patient selection for VP shunt.
Read more References Gonzalo Domínguez M, Hernández Rodríguez MC, Juanes Méndez JA, Santirso Abuelbar L, Santos Motón C, Martin García I. Hallazgos de TC y RM en el diagnóstico de la Hidrocefalia Crónica del Adulto. seram [Internet]. 2018. Nazwar TA, Bal’afif F, Wardhana DW, Yueniwati Y, Pradana W. Imaging of normal pressure hydrocephalus. Journal of Cardiovascular, Neurovascular & Stroke. 2023:4(4):1-12. https://doi.org/10.32896/cvns.v4n4.1-12 Damasceno BP. Neuroimaging in normal pressure hydrocephalus. 2018. https://doi.org/10.6084/m9.figshare.7517378 He W, Fang X, Wang X et al. A New Index for Assessing Cerebral Ventricular Volume...
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