PRE- AND POST- SHUNT CEREBRAL PERFUSION MEASURED BY DYNAMIC SUSCEPTIBILITY CONTRAST MRI IN PATIENTS WITH NORMAL PRESSURE HYDROCEPHALUS.

Abstract

Background: NPH-related dementia is the only surgically manageable dementia. Response to ventricular shunting in NPH is variable. This study aims to establish a possible correlation between the changes in cerebral perfusion with clinical response to shunting. The study group consisted of Methods: 20 patients with NPH diagnoses who underwent ventricular shunting. Pre- and 3-month post- shunt DSC-MRI was done to assess the change in relative cerebral blood ow (rCBF). Mean ± SD values of rCBF in frontal grey matter, frontal periven Results: tricular white matter, parietal periventricular white matter and hippocampus were 0.91 ± 0.11, 0.61 ± 0.09, 0.47 ± 0.11 and 0.93 ± 0.06 before shunt surgery and 0.98 ± 0.06, 0.70 ± 0.07, 0.54 ± 0.07 and 0.98 ± 0.06 after shunt surgery in NPH patients who responded to shunt surgery; and 0.78 ± 0.17, 0.37 ± 0.14, 0.41 ± 0.11 and 0.89 ± 0.10 before shunt surgery and 0.79 ± 0.14, 0.37 ± 0.19, 0.38 ± 0.09 and 0.84 ± 0.07 after shunt surgery in NPH patients who did not respond to shunt surgery. Therefore, regional rCBF in these regions increased in responders after shunt surgery, with a signicant statistical difference (p-value < 0.05) while no signicant change was seen in shunt non-responders (p-value > 0.05). There is a correlation between a si Conclusion: gnicant increase in regional rCBF and clinical improvement after shunt surgery.