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Correlation between tap test and CSF aqueductal stroke volume in idiopathic normal pressure hydrocephalus.
[hydrocephalus with stenosis of the aqueduct of sylvius]
The
diagnosis
and
management
of
idiopathic
normal
pressure
hydrocephalus
(
INPH
)
remains
unclear
despite
the
development
of
guidelines
.
In
addition
,
the
role
of
cerebrospinal
fluid
(
CSF
)
aqueductal
stroke
volume
(
ASV
)
remains
unspecified
.
The
aim
of
this
study
was
to
compare
the
results
of
the
tap
test
(
TT
)
and
ASV
in
patients
with
possible
INPH
.
Among
21
patients
investigated
with
both
TT
and
phase-contrast
(
PC
)
MRI
,
we
identified
two
groups
,
with
either
(
1
)
a
positive
TT
(
PTT
)
or
(
2
)
a
negative
one
(
NTT
)
,
and
we
compared
their
ASV
as
measured
by
PC
-MRI
.
ASV
cutoff
value
was
set
at
70
μL
/
cardiac
cycle
(
mean
value
+
2
standard
deviations
in
age-matched
healthy
subjects
)
.
In
the
PTT
group
(
n
=
9
)
,
the
mean
ASV
was
175
±
71
μL
.
Among
these
patients
,
four
were
shunted
,
and
improved
after
surgery
.
In
the
NTT
group
,
two
patients
were
finally
diagnosed
with
aqueductal
stenosis
and
excluded
.
Among
the
remaining
patients
(
n
=
10
)
,
the
mean
ASV
was
96
±
93
μL
(
p
<
0
.
05
)
.
However
,
three
of
these
patients
presented
with
hyperdynamic
ASV
,
and
an
associated
neurodegenerative
disorder
was
diagnosed
.
Two
patients
had
ventriculoperitoneal
shunting
despite
their
NTT
,
and
improved
.
In
our
patient
population
,
the
noninvasive
measurement
of
hyperdynamic
ASV
correlated
with
PTT
,
suggesting
PC
-MRI
could
be
utilized
to
select
those
patients
who
would
benefit
from
shunting
.
ASV
may
therefore
be
an
interesting
supplemental
diagnosis
tool
.
Diseases
Validation
Diseases presenting
"idiopathic normal pressure"
symptom
hydrocephalus with stenosis of the aqueduct of sylvius
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