Mechanisms in hydrocephalus revealed by neuroimaging

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Conclusions • Numerous advanced techniques available for evaluating functional changes in hydrocephalus • Abundant hypotheses wrt mechanisms • Experimental model systems needed … but how relevant are they to human hydrocephalus • HC is multi-factorial - multi-modality studies needed • Standardization is critical (esp. wrt CSF flow)
Acknowledgements Pat McAllister, PhD, Utah Shams Rashid, PhD, Stony Brook Martin Schuhmann, MD, Tubingen Jack Walker, MD, Utah Brain Child Foundation Batterman Family Foundation STARS-kids Foundation Thanks for sharing data Noam Alperin, PhD, Univ. of Miami Olivier Baledent, PhD, University Hospital of Picardie Jules Verne, Amiens, Franceh Ingolf Sack, PhD, Department of Radiology, Charite´ – Universitatsmedizin, Berlin
Page 1 and 2: Neuroimaging approaches for elucida
Page 3 and 4: Neurology. 2012 Jul 3. [Epub ahead
Page 5 and 6: CSF flow Techniques • Cine phase
Page 7 and 8: There is abundant literature on the
Page 9 and 10: Toward mechanisms - Relationship be
Page 11 and 12: Changes Is there a in relationship
Page 13 and 14: Possible confounds - Physiological
Page 15 and 16: 4D phase contrast imaging - but wha
Page 17 and 18: time Real-time CSF flow during phys
Page 19 and 20: How is Compliance Measured Invasive
Page 21 and 22: The Physiologic Basis of MR-ICP IC
Page 23 and 24: How is dP Measured? • The pressur
Page 25 and 26: MR Elastography Freimann et al, Neu
Page 27 and 28: … but no change in compliance wit
Page 29 and 30: CBF Techniques - 133 Xe-CT - 15 O
Page 31 and 32: CBF by PET (NPH) CBF decreased, glo
Page 33 and 34: CBF by PCMRI • Increased with shu
Page 35 and 36: CBF by SPECT CBF marginally changed
Page 37 and 38: Diffusion Techniques • MRI - Dif
Page 39 and 40: Why would diffusion NOT be isotropi
Page 41 and 42: First demonstration of DTI changes
Page 43 and 44: ↓ FA increased, ↑MD in iNPH not
Page 45 and 46: FA/MD in corticospinal tract Correl
Page 47 and 48: Increased FA in caudate … improve
Page 49 and 50: Liliefeld et al, JNSPeds 2009
Page 51: Functional MRI ???

Mechanisms in hydrocephalus revealed by neuroimaging

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