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Choroidal fissure acts as an overflow device in cerebrospinal fluid drainage: morphological comparison between idiopathic and secondary normal-pressure hydrocephalus
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Choroidal fissure acts as an overflow device in cerebrospinal fluid drainage: morphological comparison between idiopathic and secondary normal-pressure hydrocephalus
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Journal Article
Choroidal fissure acts as an overflow device in cerebrospinal fluid drainage: morphological comparison between idiopathic and secondary normal-pressure hydrocephalus
2016
Overview
To clarify the pathogenesis of two different types of adult-onset normal-pressure hydrocephalus (NPH), we investigated cerebrospinal fluid distribution on the high-field three-dimensional MRI. The subarachnoid spaces in secondary NPH were smaller than those in the controls, whereas those in idiopathic NPH were of similar size to the controls. In idiopathic NPH, however, the basal cistern and Sylvian fissure were enlarged in concurrence with ventricular enlargement towards the z-direction, but the convexity subarachnoid space was severely diminished. In this article, we provide evidence that the key cause of the disproportionate cerebrospinal fluid distribution in idiopathic NPH is the compensatory direct CSF communication between the inferior horn of the lateral ventricles and the ambient cistern at the choroidal fissure. In contrast, all parts of the subarachnoid spaces were equally and severely decreased in secondary NPH. Blockage of CSF drainage from the subarachnoid spaces could cause the omnidirectional ventricular enlargement in secondary NPH.
Publisher
Nature Publishing Group UK,Nature Publishing Group
Subject
/ Aged
/ Cerebrospinal Fluid Leak - diagnostic imaging
/ Cerebrospinal Fluid Leak - physiopathology
/ Choroid Plexus - abnormalities
/ Choroid Plexus - diagnostic imaging
/ Choroid Plexus - physiopathology
/ Female
/ Humanities and Social Sciences
/ Humans
/ Hydrocephalus, Normal Pressure - classification
/ Hydrocephalus, Normal Pressure - diagnostic imaging
/ Hydrocephalus, Normal Pressure - pathology
/ Hydrocephalus, Normal Pressure - physiopathology
/ Lateral Ventricles - abnormalities
/ Lateral Ventricles - diagnostic imaging
/ Lateral Ventricles - physiopathology
/ Magnetic Resonance Imaging - methods
/ Male
/ Overflow
/ Pressure
/ Science
/ Subarachnoid Space - abnormalities
/ Subarachnoid Space - diagnostic imaging
