PURPOSE: In the older patient with dilated ventricles, it is often difficult to differentiate normal pressure hydrocephalus (NPH) from cerebral atrophy caused by Alzheimer disease (AD). This study was undertaken to see if dilatation of the perihippocampal fissures (PHFs) could be used as a distinguishing characteristic of these two disorders. METHODS: MR images of 17 patients with AD were compared with those from an equal number of patients with NPH who improved after ventriculoperitoneal shunting. The PHFs, lateral ventricles, third ventricle, and temporal horns were graded subjectively. Objective, computer-aided volumetric measurements of the PHFs and lateral ventricles were obtained. The preshunt images of the NPH patients were evaluated. RESULTS: Significant differences between the two groups were found for the PHFs and lateral ventricles by both the subjective and objective methods, with a high degree of correlation between the two methods. CONCLUSION: The degree of dilatation of PHFs appears to be a sensitive and specific marker for differentiating AD from NPH by both subjective and objective means, with a very small overlap between the two groups. This observation may have relevance in day-to-day practice.
PURPOSE: In the older patient with dilated ventricles, it is often difficult to differentiate normal pressure hydrocephalus (NPH) from cerebral atrophy caused by Alzheimer disease (AD). This study was undertaken to see if dilatation of the perihippocampal fissures (PHFs) could be used as a distinguishing characteristic of these two disorders. METHODS: MR images of 17 patients with AD were compared with those from an equal number of patients with NPH who improved after ventriculoperitoneal shunting. The PHFs, lateral ventricles, third ventricle, and temporal horns were graded subjectively. Objective, computer-aided volumetric measurements of the PHFs and lateral ventricles were obtained. The preshunt images of the NPH patients were evaluated. RESULTS: Significant differences between the two groups were found for the PHFs and lateral ventricles by both the subjective and objective methods, with a high degree of correlation between the two methods. CONCLUSION: The degree of dilatation of PHFs appears to be a sensitive and specific marker for differentiating AD from NPH by both subjective and objective means, with a very small overlap between the two groups. This observation may have relevance in day-to-day practice.
Authors: C R Jack; D W Dickson; J E Parisi; Y C Xu; R H Cha; P C O'Brien; S D Edland; G E Smith; B F Boeve; E G Tangalos; E Kokmen; R C Petersen Journal: Neurology Date: 2002-03-12 Impact factor: 9.910
Authors: M Ivkovic; B Liu; F Ahmed; D Moore; C Huang; A Raj; I Kovanlikaya; L Heier; N Relkin Journal: AJNR Am J Neuroradiol Date: 2012-12-20 Impact factor: 3.825
Authors: Yafell Serulle; Henry Rusinek; Ivan I Kirov; Hannah Milch; Els Fieremans; Alexander B Baxter; John McMenamy; Rajan Jain; Jeffrey Wisoff; James Golomb; Oded Gonen; Ajax E George Journal: J Neurol Date: 2014-08-01 Impact factor: 4.849