Reappraisal of radionuclide cisternography in the diagnosis of chronic hydrocephalus—A single institution report

Abstract

Functional classification of hydrocephalus into “obstructive” and “communicating” used to form a scheme regarding diagnosis and treatment but is nowadays considered outdated. We present our retrospective clinical experience with a series of patients with signs and symptoms of chronic hydrocephalus that were investigated by radionuclide cisternography (RC) and discuss the method's possible contemporary role. During the past five years, RC was used during the investigation of 12 possible hydrocephalus patients (5 male, 7 female, ages 26 to 77 years, mean 59.5, std 18.19). The patients' symptoms ranged from headache to gait disturbance, dementia and urine incontinence. Patients were investigated with CT and MRI scans and had an RC examination using In-111-DTPA. According to the RC results the patients were divided into three groups: 5 patients with chronic hydrocephalus, 2 patients with borderline hydrocephalus and 5 patients without hydrocephalus, based on the delay of radioisotope drainage from the subarachnoid space. The clinical presentation was the chief reasoning in the decision for shunting of patients diagnosed with chronic hydrocephalus. No conclusive outcomes were produced by our experience, however, RC might be under researched and could potentially complement modern MRI studies of CSF spaces (i.e. CISS or FIESTA).

Keywords

• Cisternogram
• Chronic hydrocephalus
• Normal pressure hydrocephalus
• Ventriculoperitoneal shunt