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The idiopathic normal-pressure hydrocephalus Radscale: a radiological scale for structured evaluation
Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience.ORCID iD: 0000-0002-4686-0941
Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience.
Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience.
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2018 (English)In: European Journal of Neurology, ISSN 1351-5101, E-ISSN 1468-1331, Vol. 25, no 3, p. 569-576Article in journal (Refereed) Published
Abstract [en]

Background and purpose: Despite the important role of imaging in diagnosing idiopathic normal‐pressure hydrocephalus (iNPH), a structured overall assessment of radiological signs is still lacking. The purpose of this study was to construct a radiological scale, composed of morphological signs of iNPH, and compare it with clinical symptoms.

Methods: In this prospective, population‐based study of iNPH, 168 individuals (93 females) [mean age 75 (range 66–92) years] underwent computed tomography of the brain and a neurological examination with assessment of clinical symptoms according to Hellström's iNPH scale. Two radiologists, blinded to clinical data, independently evaluated and measured eight radiological parameters, i.e. Evans’ index, callosal angle, size of temporal horns, narrow high‐convexity sulci, dilated Sylvian fissures, focally dilated sulci, peri‐ventricular hypodensities and bulging of the lateral ventricular roof.

Results: In a linear regression model, all parameters except ventricular roof bulging were significantly associated with clinical iNPH symptoms. The seven remaining parameters were summarized into a total iNPH Radscale score ranging from 0 to 12. There was a significant correlation (r = 0.55, < 0.001) between the total iNPH Radscale score and clinical symptoms. The inter‐rater agreement for the included radiological parameters was high (intraclass correlation, 0.74–0.97).

Conclusion: The iNPH Radscale may become a valuable diagnostic screening tool, allowing a structured radiological assessment. A high iNPH Radscale score together with clinical symptoms should raise suspicion of iNPH, motivating further evaluation for shunt surgery.

Place, publisher, year, edition, pages
2018. Vol. 25, no 3, p. 569-576
Keyword [en]
computed tomography, neurologic gait disorders, normal pressure hydrocephalus, memory disorders
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
URN: urn:nbn:se:umu:diva-145580DOI: 10.1111/ene.13555ISI: 000425631500025PubMedID: 29281156OAI: oai:DiVA.org:umu-145580DiVA, id: diva2:1192239
Available from: 2018-03-22 Created: 2018-03-22 Last updated: 2018-06-09Bibliographically approved

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Kockum, KarinLilja-Lund, OttoLaurell, Katarina

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