Normal Pressure Hydrocephalus
Conditions
Keywords
Normal pressure hydrocephalus, flow MRI, dementia, cerebrospinal fluid, shunt
Brief summary
The idea is to assess the predictive value of flow magnetic resonance imaging (flow MRI) for patient suffering normal pressure hydrocephalus (NPH) planned for surgery. By now, the depletive lumbar puncture is the best test assessing the efficacy of a forthcoming surgery. The idea is to demonstrate that flow MRI can be as effective as lumbar puncture in term of predictive value of surgery response. In that way, cerebrospinal fluid (CSF) dynamics are evaluated by a single non invasive examination. CSF flow is measured at the Sylvius' aqueduct, cervical, arachnoid space and 4th ventricle levels.
Interventions
OTHERclinical and imaging examinations
Quantitative CSF flow study was performed by 2D phase-contrast velocity-encoded cine MRI (repetition/echo time, 15/7 ms; field of view = 140 x 140 mm²; matrix size = 256 x 128, flip angle = 25 degrees,one excitation, slice thickness = 5 mm). Cerebrospinal fluid flow was measured with a velocity-encoding value of 10-20 cm/s. Peripheral gating was used to cover the entire cardiac cycle with retrospective cardiac synchronization of 32 quantitative flow-encoded images per cycle. Clinical examination consists in neuropsychological assessment (including mini mental state examination test and Bradley's scale) as well as Hakim's triad evaluation
Sponsors
Centre Hospitalier Universitaire, Amiens
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
20 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* age: over 20 years * diagnostic of normal pressure hydrocephalus * ventricular dilation visible on radiological examination * patients gave their written informed consent
Exclusion criteria
* age: less than 20 years * MRI contra-indication * pregnancy * lumbar puncture within 48 hours before MRI * cardiac arrhythmia * cerebral/lacunar stroke
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| CSF stroke volume | Day 1 | Measurement of CSF stroke volume via flow MRI at the Sylvius' aqueduct level |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Hakim's triad evaluation | Day 1 | Assessment of the signs of normal pressure hydrocephalus |
| Neuropsychological test | Day 1 | classical neuropsychological assessment (including mini mental status evaluation) |
| CSF stroke volume | Day 60 | Measurement of CSF stroke volume by flow MRI at the Sylvius' aqueduct level (follow-up) |
Countries
France
Outcome results
None listed