Cerebrospinal fluid flow waveforms - MR analysis in chronic adult hydrocephalus

RATIONALE AND OBJECTIVES. TO analyze changes in cerebrospinal fluid (CSF) h ydrodynamics in chronic adult hydrocephalus, METHODS. Phase-contrast cine-MR acquisitions were used to explore the ventr icular system and the upper ventral cervical spaces of 16 patients. The aqu eductal jet was explored in 32 control subjects. RESULTS. The duration of pulsatile caudal CSF flow (ie, CSF systole) was ab normally short in patients with active idiopathic and obstructive hydroceph alus. The duration of CSF cervical systole was normal in patients with stab le hydrocephalus. The aqueductal stroke volume could be increased in stable communicating hydrocephalus. Patients who responded to shunting had shorte ned CSF systoles and hyperpulsatile ventricular patterns. Successful CSF di version resulted in longer CSF systoles and CSF ventricular patterns that w ere no longer hyperpulsatile. CONCLUSIONS. Magnetic resonance analysis of CSF Row can show craniospinal d issociation and limitation of CSF outflow from the ventricles in both obstr uctive and communicating hydrocephalus; it should help determine the respon se to shunting in communicating hydrocephalus.