title: Preoperative prognostic value of MRI findings in 108 patients with idiopathic normal pressure hydrocephalus.
abstract: OBJECTIVE
  MR imaging is used in the diagnostic evaluation of patients with idiopathic normal pressure hydrocephalus. The aim of this study was to describe the prevalence of several imaging features and their prognostic use in the selection of shunt candidates with idiopathic normal pressure hydrocephalus.
  
  
  METHODS
  Preoperative MR imaging scans of the brain were retrospectively evaluated in 108 patients with idiopathic normal pressure hydrocephalus who had undergone a standardized, clinical evaluation before and 12 months after shunt surgery. The MR imaging features investigated were the Evans index, callosal angle, narrow sulci at the high convexity, dilation of the Sylvian fissure, diameters of the third ventricle and temporal horns, disproportionately enlarged subarachnoid space hydrocephalus, flow void through the aqueduct, focal bulging of the roof of the lateral ventricles, deep white matter hyperintensities, periventricular hyperintensities, and focal widening of sulci and aqueductal stenosis.
  
  
  RESULTS
  In logistic regression models, with shunt outcome as a dependent variable, the ORs for the independent variables, callosal angle, disproportionately enlarged subarachnoid space hydrocephalus, and temporal horns, were significant (P < .05), both in univariate analyses and when adjusted for age, sex, and previous stroke.
  
  
  CONCLUSIONS
  A small callosal angle, wide temporal horns, and occurrence of disproportionately enlarged subarachnoid space hydrocephalus are common in patients with idiopathic normal pressure hydrocephalus and were significant predictors of a positive shunt outcome. These noninvasive and easily assessed radiologic markers could aid in the selection of candidates for shunt surgery.
authors.affiliation: From the Departments of Neuroscience and Neurology (J.V., K.L.) johan.virhammar@neuro.uu.se.
authors.forename: J
authors.initials: J
authors.lastname: Virhammar
authors.affiliation: From the Departments of Neuroscience and Neurology (J.V., K.L.) Department of Pharmacology and Clinical Neuroscience (K.L.), Östersund, Umeå University, Umeå, Sweden.
authors.forename: K
authors.initials: K
authors.lastname: Laurell
authors.affiliation: Neuroscience and Neurosurgery (K.G.C.).
authors.forename: K G
authors.initials: KG
authors.lastname: Cesarini
authors.affiliation: Radiology (E.-M.L.), Uppsala University, Uppsala, Sweden.
authors.forename: E-M
authors.initials: EM
authors.lastname: Larsson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002535:Cerebral Aqueduct / Q000002:abnormalities / Q000473:pathology; D002557:Cerebrospinal Fluid Shunts; D004108:Dilatation, Pathologic; D005260:Female; D040181:Genetic Diseases, X-Linked; D006801:Humans; D006849:Hydrocephalus; D006850:Hydrocephalus, Normal Pressure / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011379:Prognosis; D013346:Subarachnoid Space / Q000473:pathology