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Increase in callosal angle and decrease in ventricular volume after shunt surgery in patients with idiopathic normal pressure hydrocephalus
Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.ORCID iD: 0000-0002-7504-8354
2019 (English)In: Journal of Neurosurgery, ISSN 0022-3085, E-ISSN 1933-0693, Vol. 130, no 1, p. 130-135Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE

Postoperative decrease in ventricle size is usually not detectable either by visual assessment or by measuring the Evans index in patients with idiopathic normal pressure hydrocephalus (iNPH). The aim of the present study was to investigate whether the angle between the lateral ventricles (the callosal angle [CA]) increases and ventricular volume decreases after shunt surgery in patients with iNPH.

METHODS

Magnetic resonance imaging of the brain was performed before and 3 months after shunt surgery in 18 patients with iNPH. The CA and Evans index were measured on T1-weighted 3D MR images, and ventricular volume contralateral to the shunt valve was measured with quantitative MRI.

RESULTS

The CA was larger postoperatively (mean 78°, 95% CI 69°–87°) than preoperatively (mean 67°, 95% CI 60°–73°; p < 0.001). The volume of the lateral ventricle contralateral to the shunt valve decreased from 73 ml (95% CI 66–80 ml) preoperatively to 63 ml (95% CI 54–72 ml) postoperatively (p < 0.001). The Evans index was 0.365 (95% CI 0.35–0.38) preoperatively and 0.358 (95% CI 0.34–0.38) postoperatively (p < 0.05). Postoperative change of CA showed a negative correlation with change of ventricular volume (r = −0.76, p < 0.01).

CONCLUSIONS

In this sample of patients with iNPH, the CA increased and ventricular volume decreased after shunt surgery. The relative difference was most pronounced for the CA, indicating that this accessible, noninvasive radiological marker should be evaluated further as an indirect method to determine shunt function in patients with iNPH.

Place, publisher, year, edition, pages
American Association of Neurological Surgeons , 2019. Vol. 130, no 1, p. 130-135
Keywords [en]
normal pressure hydrocephalus, callosal angle, Evans index, postoperative radiology, quantitative MRI, NPH, shunt dysfunction
National Category
Neurology
Identifiers
URN: urn:nbn:se:umu:diva-155641DOI: 10.3171/2017.8.JNS17547ISI: 000454604000015PubMedID: 29393749OAI: oai:DiVA.org:umu-155641DiVA, id: diva2:1282655
Funder
Erik, Karin och Gösta Selanders FoundationAvailable from: 2019-01-25 Created: 2019-01-25 Last updated: 2019-01-25Bibliographically approved

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Laurell, Katarina

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