Document Detail

Focal dilation and paradoxical collapse of cortical fissures and sulci in patients with normal-pressure hydrocephalus.
MedLine Citation:
PMID:  9817411     Owner:  NLM     Status:  MEDLINE    
OBJECT: The authors describe a subgroup of patients with shunt-proven normal-pressure hydrocephalus (NPH) who presented with focal fissural and sulcal dilation on imaging studies. The specific radiological features and methods of differentiating this condition from cortical atrophy are delineated. METHODS: Normal-pressure hydrocephalus has been described as dilation of the ventricles that is out of proportion to the sulci. Sulcal dilation has been taken as evidence of cortical atrophy and has even been used as a criterion to exclude patients from undergoing a shunting procedure. The authors describe five cases of patients with shunt-proven NPH who presented with focal dilation of cortical fissures and sulci. In three of the cases, there was a paradoxical decrease in the size of the dilated fissures and sulci that paralleled the decrease in the size of the lateral ventricles following successful shunting. CONCLUSIONS: This study demonstrates that focal fissural and sulcal dilation may represent reservoirs of cerebrospinal fluid analogous to the ventricular system. Patients should not be denied a shunting procedure solely on the basis of focally dilated fissures of sulci.
A I Holodny; A E George; M J de Leon; J Golomb; A J Kalnin; P R Cooper
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  89     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  1998 Nov 
Date Detail:
Created Date:  1998-12-04     Completed Date:  1998-12-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  742-7     Citation Subset:  AIM; IM    
Department of Radiology, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark 07103-2714, USA.
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MeSH Terms
Aged, 80 and over
Atrophy / diagnosis
Cerebral Cortex / pathology,  radiography
Diagnosis, Differential
Hydrocephalus, Normal Pressure / diagnosis*
Tomography, X-Ray Computed

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