Login      Sign Up
 

Q. Kindly explain whether MRI brain and CSF studies show any relation to NPH.

Answered by Dr. Vivek Chail.


New
Do you have a question on Normal Pressure Hydrocephalus or Csf? We have medical experts to help you right away. Ask a Doctor Now »
 

Hello doctor,

Can you please give the diagnosis of the uploaded MRI brain and CSF studies with a detailed report? Please advise on the action plan as to how to get the CSF findings treated. The MRI report is enclosed. Does the enclosed report co-relate with your findings? The MRI report CSF studies report shows CSF hyperdynamic flow of absolute stroke volume of 110 microliters per second against the normal of 50 microliters per sec per cardiac cycle. Also, my treating neurologist wanted an opinion on the following. Are there signs of NPH? But do the findings of brain atrophy, ventriculomegaly, hyperdynamic CSF flows suggest of idiopathic hydrocephalus and are some intervention required?


Related Questions:
I have hyperreflexia. Can this be neurological?
What is the white mass seen above my teeth in MRI?
Why did the doctors ask for my signature during LP procedure?
 

Dr. Vivek Chail
MBBS., DMRD., DNB (RADIODIAGNOSIS
Radiodiagnosis, Radiology

Hi,

Welcome back to icliniq.com.

The findings in the report and the images are matching and acceptable (attachment removed to protect patient identity). The term NPH is usually applied in cases where there is abnormal CSF hyperdynamic circulation with gait problems or without gait problems if incontinence is there. Confirming NPH without typical features is difficult in your case. There are controversies regarding NPH and CSF hyperdynamic values and different researchers have come to variable conclusions. Since gait problems are most common in NPH, therefore, most researches have mentioned the importance of gait problems when confirming NPH or incontinence if gait problem is not there.

Treatment with shunting might help only when NPH is confirmed. If there is no NPH then the diagnosis is likely due to neurodegenerative disorders and the symptoms can be treated by medicines. There are many different and complicated types of neurodegenerative disorders and a clinical emphasis is more important than only MRI findings when confirming a condition.

 

Thank you doctor,

A couple of clarifications.

Are there CSF Flow circulations abnormalities as per the images? There are gait problems which is the most prominent feature in my case. Now there are also frequent falls and imbalance with head reeling. There are frequent episodes of urinary incontinence. The asymmetrical atrophy could be due to neurodegenerative disease. Are the CSF findings due to NPH or any other CSF flow disorders which may have to be further investigated? Please could you clarify on the above. It would be highly helpful for treatment by my neurologist.

 

Dr. Vivek Chail
MBBS., DMRD., DNB (RADIODIAGNOSIS
Radiodiagnosis, Radiology

Hi,

Welcome back to icliniq.com.

The CSF flow abnormalities are calculated by the MRI machine using available data and there is high accuracy in calculations and therefore the chances of error in the displayed values are less. It is important for you to follow up closely with your neurologist. If needed, then a second MRI with CSF flow might help to know the pattern of change in stroke volume with the progression of the condition.

I understand that your clinical symptoms and signs are closely resembling idiopathic NPH but it can get difficult to confirm a diagnosis based on a single scan report. Neurodegenerative disease can also cause overlapping symptoms. The treatment for idiopathic NPH is usually shunting but your diagnosis must be confirmed before treatment can be given. As a radiologist, my suggestion will be to review the scan after six months and this is to know if the flow of the CSF is following any reversal or any other changes. However please discuss in detail with your neurologist for a detailed evaluation of your symptoms and possible options for treatment.

 
 
Ask your health query to a doctor online?
 
Ask a Doctor Online »
* guaranteed answer within 4 hours.

Related Questions & Answers


How to treat headaches caused by tuberculous meningitis?
Query: Hello doctor, My father was suffering from fever and right sided headaches, which felt like an electric shock. So, we consulted a doctor, and after several tests, the doctor diagnosed it as tubercular meningitis. All the test including CT scan were normal. So, he prescribed Forcox, Benadon, and Uri...  Read Full »
Dr. Hitesh Kumar
Neurologist

Answer: Hello, Welcome to icliniq.com. I would like to know few more details. Since when is he on tuberculosis medicines? Since when is he having fever and headaches? How long does one episode of the headache last? Does he have any nausea or vomiting during the headache? Does this headache increase on lyin...  Read Full »
 
I have hyperreflexia. Can this be neurological?
Query: Hello doctor, I am 37 years old. Three years ago I had spine surgery for herniated disc L5-S1. After the surgery strange symptoms began. Four hours after surgery when I tried to sleep I got myoclonic jerks. Then I had problem with ligaments. My ligaments started to stretch so easily that I began ...  Read Full »
Dr. Lalit Bansal
Neurologist

Answer: Hi, Welcome to icliniq.com. With MRI brain, spine, EMG (electromyography) and genetic workup being normal, it seems unlikely to be neurological. One think to look at would be what anesthetic agents or medicine you received during your surgery. If it has any long term such side effects then please p...  Read Full »
 
There is a white mass above my teeth in MRI. What is it?
Query: Hello doctor, I had a brain MRI nine months ago. The report came back completely normal. I decided to look at the images last night and I noticed this bright white mass above my teeth. Either the mass is near my teeth or in my sinuses. I am worried that I have a tumor growing and it was looked over...  Read Full »
Dr. Chitrangada
Radiologist

Answer: Hi, Welcome to icliniq.com. The MRI brain looks normal (attachment removed to protect patient identity). The bright spot on the right side is a small right maxillary sinus polyp which is completely benign. Take care.  Read Full »
 
 

Ask your health query to a doctor online?
 
Ask a Doctor Online »
* guaranteed answer within 4 hours.
 

Ask a Doctor Online

* guaranteed answer within 4 hours
 

Most Viewed


My nose is always blocked and has mucus. Kindly help.
Hello doctor,My nose is always blocked and have mucus, from past four months. To open up my nostrils, I have to use Otri ...Read more »
Child is showing tantrums and speaking bad words. Kindly help.
Hello doctor, My child is 2.7 years old but is very aggressive and does what should not be done. Never listens, shows t ...Read more »
Folic Acid - Uses | Dosage | Side effects | Drug Interactions | Warnings
Folic acid is the synthetic form of folate, which is a water-soluble vitamin B9. It is the crucial ingredient in the syn ...Read more »
 
 

Also Read Answers From