What is it about?
The relationship between disturbed CSF circulation and autoregulation of cerebral blood flow could reveal commorbidities ("pure" hydrocephalus versus hydrocephalus with some cerebrovascular burden), differential diagnoses between hydrocephalus and eg a vascular disease. The assessment of these parameters can be performed at the same time, with lower cost and good reliability using infusion studies.
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Why is it important?
The diagnosis and outcome prognostication of NPH needs significant optimisation, since there is an increasing incidence of dementias and therefore NPH, as well as significant amount of underdiagnosis, and even arguably overdiagnosis in some centres. Cerebral blood flow assessments have been performed in these patients
Perspectives
NPH needs holistic and interdisciplinary approach, as long as detailed assessment of CSF dynamics combined with clinical signs and cerebral blood flow & autoregulation investigations. All these can be collated to a puzzle differentiating between "pure" NPH, NPH with commorbidities and ,possibly, no NPH. Detailed, combined investigations of CSF circulation and cerebral blood flow should be combined, with aim to then associating these findings with outcome and powering a prospective outcome study
Afroditi Lalou
Umea Universitet
Read the Original
This page is a summary of: Cerebral autoregulation, cerebrospinal fluid outflow resistance, and outcome following cerebrospinal fluid diversion in normal pressure hydrocephalus, Journal of Neurosurgery, March 2018, Journal of Neurosurgery Publishing Group (JNSPG),
DOI: 10.3171/2017.7.jns17216.
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