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01-03-2022 | Hydrocephalus | Original Article

Progressive supranuclear palsy with marked ventricular dilatation mimicking normal pressure hydrocephalus

Authors: Andrea Quattrone, Alessia Sarica, Domenico La Torre, Maurizio Morelli, Alessandro Mechelli, Pier Paolo Arcuri, Aldo Quattrone

Published in: Neurological Sciences | Issue 3/2022

Abstract

Background

Progressive supranuclear palsy (PSP) patients can show ventricular enlargement mimicking normal pressure hydrocephalus (NPH). The aim of this study was to distinguish PSP patients with marked ventricular dilatation (PSP-vd) from those with normal ventricular system and to evaluate the coexistence of NPH in PSP-vd patients.

Methods

One hundred three probable PSP patients, 18 definite NPH patients, and 41 control subjects were enrolled in the study. Evans index (EI) > 0.32 associated with callosal angle (CA) < 100° was used to identify PSP-vd patients. Automated ventricular volumetry (AVV) and Magnetic Resonance Hydrocephalic Index (MRHI) were performed on T1-weighted MR images to evaluate the presence of NPH in PSP-vd patients.

Results

Twelve (11.6%) out of 103 PSP patients had both abnormal EI and CA values (PSP-vd). In two of these 12 patients, AVV and MRHI values suggested PSP + NPH. In the remaining 10 PSP-vd patients, AVV and MRHI values were higher than PSP patients with normal ventricular system and controls, but lower than PSP + NPH and NPH patients, suggesting a non-hydrocephalic ventricular enlargement.

Discussion

Our study provides evidence that the combination of EI and CA biomarkers allowed to identify PSP patients with marked ventricular dilatation mimicking NPH. Only a few of these patients had PSP + NPH. Recognition of these PSP patients with enlarged ventricles can positively impact the care of this disease, helping clinicians to identify patients with PSP + NPH who could benefit from shunt procedure and avoid surgery in those with enlarged ventricles without NPH.

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Title: Progressive supranuclear palsy with marked ventricular dilatation mimicking normal pressure hydrocephalus
Authors: Andrea Quattrone
Alessia Sarica
Domenico La Torre
Maurizio Morelli
Alessandro Mechelli
Pier Paolo Arcuri
Aldo Quattrone
Publication date: 01-03-2022
Publisher: Springer International Publishing
Keywords: Hydrocephalus
Hydrocephalus
Hydrocephalus
Progressive Supranuclear Palsy
Published in: Neurological Sciences / Issue 3/2022
Print ISSN: 1590-1874
Electronic ISSN: 1590-3478
DOI: https://doi.org/10.1007/s10072-021-05594-4

At a glance: The STEP trials

Springer Medicine

Progressive supranuclear palsy with marked ventricular dilatation mimicking normal pressure hydrocephalus

Abstract

Background

Methods

Results

Discussion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Discussion

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