Abstract
An interleaved velocity-sensitised fast low-angle shot pulse sequence was used to study cerebrospinal fluid (CSF) flow in the cerebral aqueduct, and supratentorial CSF production in 9 patients with normal pressure hydrocephalus (NPH) and 9 healthy volunteers. The peak aqueduct CSF flow, both caudal and rostral, was significantly increased in patients with NPH. No significant difference in the supratentorial CSF production rate was found between patients (mean 0.60+/−0.59 ml/min) and healthy volunteers (mean 0.68+/−0.31 ml/min). Our method may be useful for investigation and monitoring of patients with NPH before and after ventriculoperitoneal shunt operations.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Hakim S (1964) Some observations on C.S.F. pressure. Hydrocephalic syndrome in adults with ‘normal’ C.S.F. pressure. (Recognition of a new syndrome.) Thesis No. 957, Escuela de Medicina de la Universidad Savierana, Bogatá, Columbia
Adams RD, Fisher CM, Hakim S, Ojemann RG, Sweet WH (1965) Symptomatic occult hydrocephalus with “normal” cerebrospinal fluid pressure: a treatable syndrome. N Engl J Med 273: 117–126
Hakim S, Adams RD (1965) The special clinical problem of symptomatic hydrocephalus with normal cerebrospinal fluid pressure: observations on cerebrospinal fluid hydrodynamics. J Neurol Sci 2: 307–327
Børgesen SE, Gjerris F (1982) The predictive value of conductance to outflow of CSF in normal pressure hydrocephalus. Brain 105: 65–86
Sørensen PS, Jansen EC, Gjerris F (1986) Motor disturbances in normal pressure hydrocephalus with special references to stance and gait. Arch Neurol 43: 34–38
Vorstrup S, Christensen J, Gjerris F, Sørensen PS, Thomsen AM, Paulson OB (1987) Cerebral blood flow in patients with normal-pressure hydrocephalus before and after shunting. J Neurosurg 66: 379–387
Sørensen PS, Gjerris F, Vorstrup S, Thomsen AM, Gerstenberg TC, Jansen EC (1989) Cerebral blood flow, gait disturbances and urinary incontinence in patients with normal pressure hydrocephalus: Results of shunt operation. Brain Dysfunction 2: 93–104
Gjerris F, Børgesen SE (1992) Pathophysiology of the CSF circulation. In: Crockard A, Hayward W, Hoff J (eds) Neurosurgery—The scientific basis of clinical practice, 2nd edn. Blackwell, London, pp 146–175
Du Boulay GH (1966) Pulsatile movements in the CSF pathways. Br J Radiol 39: 255–262
Du Boulay GH, O'Connell J, Currie J, Bostick T, Verity P (1972) Further investigation on pulsatile movements in the cerebrospinal fluid pathways. Acta Radiol 13: 496–523
Bradley WG, Kortman KE, Burgoyne B (1986) Flowing cerebrospinal fluid in normal and hydrocephalic states: appearance on MR images. Radiology 159: 611–616
Sherman JL, Citrin CM (1986) Magnetic resonance demonstration of normal CSF flow. AJNR 7: 3–6
Bergstrand G, Bergström M, Nordell B, Ståhlberg F, Ericsson A, Hemmingsson A, Sperber G, Thoumas KÅ, Jung B (1985) Cardiac gated MR imaging of cerebrospinal fluid flow. J Comput Assist Tomogr 9: 1003–1006
Bergstrand G, Nordell B, Ståhlberg F, Ericsson A, Bergström M, Hemmingsson A, Sperber G, Thoumas KÅ, Jung B (1986) Cerebrospinal fluid flow studied with gated magnetic resonance imaging during the various parts of the cardiac cycle. Acta Radiol (Suppl) 386: 490–491
Citrin CM, Sherman JL, Gangarosa RE, Scanlon D (1987) Physiology of the CSF flow-void sign: modification by cardiac gating. AJR 148: 205–208
Mark AS, Feinberg DA, Brandt-Zawadzki M (1987) Changes in size and magnetic resonance signal intensity of the cerebral CSF spaces during the cardiac cycle as studied by gated, high-resolution magnetic resonance imaging. Invest Radiol 22: 290–297
Edelman RR, Wedeen VJ, Davis KR, Widder D, Hahn P, Shoukimas G, Brady TJ (1986) Multiphasic MR imaging: a new method for direct imaging of pulsatile CSF flow. Radiology 161: 779–783
Mascalchi M, Ciraolo L, Tanfani G, Taverni N, Inzitari D, Siracusa GF, Dal Pozzo GC (1988) Cardiac-gated phase MR imaging of aqueductal CSF flow. J Comput Assist Tomogr 12: 923–926
Feinberg DA, Mark AS (1987) Human brain motion and cerebrospinal fluid circulation demonstrated with MR velocity imaging. Radiology 163: 793–799
Ståhlberg F, Møgelvang J, Thomsen C, Nordell B, Stubgaard M, Ericsson A, Sperber G, Greitz D, Larsson H, Henriksen O, Persson B (1989) A method for quantification of flow velocities in blood and CSF using interleaved gradient-echo pulse sequences. Magn Res Imaging 7: 655–667
Thomsen C, Ståhlberg F, Stubgaard M Nordell B, The Scandinavian Flow Group (1990) Fourier analysis of cerebrospinal fluid flow velocities: MR imaging study. Radiology 177: 659–665
Ciraolo L, Maschalchi M, Buciolini M, Dal Pozzo G (1990) Fast multiphase MR imaging of aqueductal CSF flow: 1. Study of healthy subjects. AJNR 11: 589–596
Enzmann DR, Pelc NJ (1991) Normal flow patterns of intracranial and spinal cerebrospinal fluid defined with phase-contrast cine MR imaging. Radiology 178: 467–474
Nitz WR, Bradley WG, Watanabe AS, Lee RR, Burgoyne B, O'Sullivan RM, Herbst MD (1992) Flow dynamics of cerebrospinal fluid: assessment with phase contrast velocity MR imaging performed with retrospective cardiac gating. Radiology 183: 395–405
Nielsson C, Ståhlberg F, Thomsen C, Henriksen O, Herning M, Owman C (1992) Circadian variation in human cerebrospinal fluid production measured by magnetic resonance imaging. Am J Physiol 262: R20-R24
Gjerris F, Børgesen SE, Sørensen PS, Boesen F, Schmidt K, Harmsen A, Lester J (1987) Resistance to cerebrospinal fluid outflow and intracranial pressure in patients with hydrocephalus after subarachnoid haemorrhage. Acta Neurochir 88: 79–86
Gjerris F, Børgesen SE (1992) Current concepts of measurement of cerebrospinal fluid absorption and biomechanics of hydrocephalus. In: Symon L et al (eds) Advances and technical standards in neurosurgery, vol 19. Springer Verlag, Wien, New York, pp 145–177
Albeck MJ, Børgesen SE, Gjerris F, Schmidt JF, Sørensen PS (1991) Intracranial pressure and cerebrospinal fluid outflow conductance in healthy subjects. J Neurosurg 74: 597–600
Bradley WG, Whittemore AR, Kortman KE, Watanabe AS, Homyak M, Teresi LM, Davis SJ (1991) Marked cerebrospinal fluid flow void: Indicator of successful shunt in patients with suspected normal-pressure hydrocephalus. Radiology 178: 459–466
Barkhof F, Kouwenhoven M, Valk J, Sprenger M (1990) Quantitative MR flow analysis in the cerebral aqueduct: controls vs communicating hydrocephalus (abstr). In: Book of abstracts: Society of Magnetic Resonance in Medicine 1990 Berkeley, Calif, Society of Magnetic Resonance in Medicine 1: 13
Mascalchi M, Ciraolo L, Bucciolini M, Inzitari D, Arnetoli G, Dal Pozo G (1990) Fast multiphase MR imaging of aqueductal CSF flow: 2. Study in patients with hydrocephalus. AJNR 11: 597–603
Quencer RM, Post MJD, Hinks RS (1990) Cine MR in the evaluation of normal and abnormal CSF flow: intracranial and intraspinal studies. Neuroradiology 32: 371–391
Barkhof F, Kouwenhoven M, Scheltens P, Sprenger M, Algra PR, Valk J (1991) Cine MR-phase study of aqueductal CSF pulsatility in normal controls. The absence of effect of aging and the relation to CSF-void on ungated modulus MR (abstr). In: Book of abstracts: Society of Magnetic Resonance in Medicine 1991. Berkeley, Calif, Society of Magnetic Resonance in Medicine 1: 299
Martin AJ, Drake JM, Lemaire C, Henkelman RM (1989) Cerebrospinal fluid shunts: Flow measurements with MR imaging. Radiology 173: 243–247
Drake JM, Martin AJ, Henkelman RM (1991) Determination of cerebrospinal fluid shunt obstruction with magnetic resonance phase imaging. J Neurosurg 75: 535–540
Gideon P, Ståhlberg F, Thomsen C, Henriksen O, Sørensen PS, Gjerris F (1992) Cerebrospinal fluid flow characteristics: a comparative study of normals and patients with benign intracranial hypertension, normal pressure hydrocephalus and high pressure hydrocephalus (abstr). In: Book of abstracts: Society of Magnetic Resonance in Medicine 1992. Berkeley, Calif, Society of Magnetic Resonance in Medicine 1: 628
Rubin RC, Henderson ES, Ommaya AK, Walker MD, Rall DP (1966) The production of cerebrospinal fluid in man and its modification by acetazolamide. J Neurosurg 25: 430–436
Cutler RWP, Page L, Galicich J, Watters GV (1968) Formation and absorption of cerebrospinal fluid in man. Brain 91: 707–720
May C, Kaye JA, Atack JR, Shapiro MB, Friedland RP, Rapoport SI (1990) Cerebrospinal fluid production is reduced in healthy aging. Neurology 40: 500–503
Davson H, Welch K, Segal MB (1987) The physiology and pathophysiology of the cerebrospinal fluid. Churchill Livingstone, Edinburgh
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Gideon, P., Ståhlberg, F., Thomsen, C. et al. Cerebrospinal fluid flow and production in patients with normal pressure hydrocephalus studied by MRI. Neuroradiology 36, 210–215 (1994). https://doi.org/10.1007/BF00588133
Issue Date:
DOI: https://doi.org/10.1007/BF00588133