title: Hydrocephalus decreases arterial spin-labeled cerebral perfusion.
abstract: OBJECTIVE
  Reduced cerebral perfusion has been observed with elevated intracranial pressure. We hypothesized that arterial spin-labeled CBF can be used as a marker for symptomatic hydrocephalus.
  
  
  METHODS
  We compared baseline arterial spin-labeled CBF in 19 children (median age, 6.5 years; range, 1-17 years) with new posterior fossa brain tumors and clinical signs of intracranial hypertension with arterial spin-labeled CBF in 16 age-matched controls and 4 patients with posterior fossa tumors without ventriculomegaly or signs of intracranial hypertension. Measurements were recorded in the cerebrum at the vertex, deep gray nuclei, and periventricular white matter and were assessed for a relationship to ventricular size. In 16 symptomatic patients, we compared cerebral perfusion before and after alleviation of hydrocephalus.
  
  
  RESULTS
  Patients with uncompensated hydrocephalus had lower arterial spin-labeled CBF than healthy controls for all brain regions interrogated (P < .001). No perfusion difference was seen between asymptomatic patients with posterior fossa tumors and healthy controls (P = 1.000). The median arterial spin-labeled CBF increased after alleviation of obstructive hydrocephalus (P < .002). The distance between the frontal horns inversely correlated with arterial spin-labeled CBF of the cerebrum (P = .036) but not the putamen (P = .156), thalamus (P = .111), or periventricular white matter (P = .121).
  
  
  CONCLUSIONS
  Arterial spin-labeled-CBF was reduced in children with uncompensated hydrocephalus and restored after its alleviation. Arterial spin-labeled-CBF perfusion MR imaging may serve a future role in the neurosurgical evaluation of hydrocephalus, as a potential noninvasive method to follow changes of intracranial pressure with time.
authors.affiliation: From the Departments of Radiology (K.W.Y.) kyeom@stanford.edu.
authors.forename: K W
authors.initials: KW
authors.lastname: Yeom
authors.affiliation: Neurosurgery (R.M.L., A.A., S.H.C., M.S.B.E.).
authors.forename: R M
authors.initials: RM
authors.lastname: Lober
authors.affiliation: Neurosurgery (R.M.L., A.A., S.H.C., M.S.B.E.).
authors.forename: A
authors.initials: A
authors.lastname: Alexander
authors.affiliation: Neurosurgery (R.M.L., A.A., S.H.C., M.S.B.E.)Division of Pediatric Neurosurgery (S.H.C., M.S.B.E.), Lucile Packard Children's Hospital at Stanford University, Palo Alto, California.
authors.forename: S H
authors.initials: SH
authors.lastname: Cheshier
authors.affiliation: Neurosurgery (R.M.L., A.A., S.H.C., M.S.B.E.)Division of Pediatric Neurosurgery (S.H.C., M.S.B.E.), Lucile Packard Children's Hospital at Stanford University, Palo Alto, California.
authors.forename: M S B
authors.initials: MS
authors.lastname: Edwards
mesh_terms: D000293:Adolescent; D000465:Algorithms; D002561:Cerebrovascular Disorders / Q000175:diagnosis* / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000150:complications* / Q000175:diagnosis*; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D007223:Infant; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013113:Spin Labels
chemical_list: D013113:Spin Labels