The role of magnetic resonance imaging cerebrospinal fluid flowmetry in differentiation between normal flow hydrocephalus and involutional brain atrophy.

OBJECTIVE

To assess the value of phase contrast magnetic resonance imaging cerebrospinal fluid flowmetry in differentiating between normal pressure hydrocephalus and involutional atrophy.

METHODS

The descriptive case-control study was conducted at the Al-Yarmouk Teaching Hospital, Baghdad, Iraq, from April to December 2017, and comprised patients with normal pressure hydrocephalus and involutional brain changes. Healthy volunteers were included as controls. Demographic data was recorded and the patients were divided according to age. Conventional magnetic resonance imaging of the brain was performed followed by the assessment of cerebrospinal fluid flow dynamics, was done at the level of the aqueduct of Sylvius. Data was analysed using SPSS 25.

RESULTS

Of the 23 subjects with a mean age of 52.3}16.8 years (range: 25-75 years), There were 13(56.5%) males and 10(43.5%) were females. Also, there were 17(74%) patients and 6(26%) controls. Among the patients, 8(47%) had brain atrophic changes based on magnetic resonance imaging, and 9(53%) had normal pressure hydrocephalus signs clinically and scanning criteria. Flowmetry showed mean systolic velocity 1.5}0.3 cm\sec, peak systolic velocity 1.5}0.3 cm\sec and systolic stroke volume 28.5}4.7μLin the control group which was significantly different from the patients (p<0.001).

CONCLUSIONS

Phase-contrast magnetic resonance imaging was found to be a useful tool to differentiate between normal pressure hydrocephalus and age-related brain atrophy.