CORRELATION BETWEEN LUMBO-VENTRICULAR PERFUSION AND MRI-CSF FLOW STUDIES IN IDIOPATHIC NORMAL-PRESSURE HYDROCEPHALUS

BACKGROUND After the initial description of normal pressure hydrocepha lus (NPH) and its clinical triad, there has been a continuous interest from clinicians and researchers to set different diagnostic criteria that would make the selection of candidates for shunt surgery easier a nd more precise. METHODS A preliminary group of 12 patients was given a diagnosis of idiopathic normal pressure hydrocephalus by clinical an d radiologic criteria. Each patient underwent two different tests: a m agnetic resonance imaging-cerebrospinal fluid (MRI-CSF) flow study and a lumbo-ventricular perfusion test. The purpose was to compare the co rrelation of the results obtained with these tests and the clinical re sults obtained after CSF diversion. Eleven patients were given shunts and one was managed with lumbar punctures. RESULTS One year after trea tment, 10 of the 12 patients had improved with good results. The MRI-C SF flow studies were reliable in six patients; there were five false n egatives and one false positive. The lumbo-ventricular perfusion test showed reliability in nine patients; there were two false negatives an d one false positive. In only three patients were the results of both of these tests in accordance with the outcome. CONCLUSIONS Even though there are few patients in this study so far, the data suggests that a t the present time the most predictive guides for the diagnosis of NPH and its outcome after shunting are the clinical criteria and the radi ological findings in computed tomography (CT) and/or MRI rather than l umbo-ventricular perfusion and CSF flow studies. (C) 1998 by Elsevier Science Inc.