Related Experiment Video

Updated: Apr 21, 2026

Modeling Posthemorrhagic Hydrocephalus of Prematurity in Rats
04:12

Modeling Posthemorrhagic Hydrocephalus of Prematurity in Rats

Published on: March 28, 2025

706

Disproportionate subarachnoid space hydrocephalus-outcome and perivascular space

Ichiro Akiguchi1, Yoshitomo Shirakashi2, Herbert Budka3

  • 1Center of Neurological and Cerebrovascular Diseases, Takeda Hospital Kyoto, Japan ; Department of Health Science, Kyoto Koka Women's University Kyoto, Japan.

Annals of Clinical and Translational Neurology
|October 31, 2014
PubMed
Abstract

Insights

Disproportionately enlarged subarachnoid space hydrocephalus (DESH-iNPH) affects 1.6% of 75-year-olds, showing lower cognitive scores and higher motor impairment. Perivascular-space narrowing may indicate this condition.

Area of Science:

  • Neurology
  • Radiology
  • Gerontology

Background:

  • Idiopathic normal pressure hydrocephalus (iNPH) is a neurological condition affecting older adults.
  • Disproportionately enlarged subarachnoid space (DESH) is an MRI feature associated with iNPH.
  • Community-based studies are crucial for understanding the prevalence and characteristics of neurological conditions in aging populations.

Purpose of the Study:

  • To determine the prevalence of DESH-iNPH in a community-based sample of 75-year-olds.
  • To describe the clinical and radiological features of DESH-iNPH.
  • To investigate the outcomes of individuals with DESH-iNPH compared to other hydrocephalus types.

Main Methods:

  • A cohort of 697 75-year-olds was assessed, with 503 undergoing detailed neurological exams, MRI, mini-mental state examination (MMSE), and Unified Parkinson Disease Rating Scale-Motor Section (UPDRSM).
  • Participants were followed for 90 months.
  • DESH-iNPH cases were compared with those exhibiting ex vacuo hydrocephalus, cerebral small-vessel diseases, and normal MRIs, including evaluation of perivascular space widening.

Main Results:

  • The prevalence of DESH-iNPH was 1.6% (8 participants), compared to 16.1% for ex vacuo hydrocephalus (76 participants).
  • DESH-iNPH participants had significantly lower MMSE scores (26.4) and higher UPDRSM scores (9.75) than controls.
  • Mortality rates after 90 months were 25.0% for DESH-iNPH, 21.3% for ex vacuo hydrocephalus, and 10.9% for normal MRIs. Perivascular-space narrowing was more pronounced in DESH-iNPH.

Conclusions:

  • DESH-iNPH has a 1.6% prevalence in 75-year-olds and is associated with poorer cognitive and motor function.
  • Perivascular-space narrowing appears to be a significant morphological and pathophysiological marker for DESH-iNPH.
  • These findings highlight the importance of recognizing DESH-iNPH in aging populations and its distinct clinical profile.

More Related Videos

Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus14:59

Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus

Published on: October 14, 2022

12.1K
Endovascular Perforation Model for Subarachnoid Hemorrhage Combined with Magnetic Resonance Imaging MRI06:30

Endovascular Perforation Model for Subarachnoid Hemorrhage Combined with Magnetic Resonance Imaging MRI

Published on: December 16, 2021

3.8K

Related Concept Videos

Cerebral Edema ll: Pathophysiology01:22

Cerebral Edema ll: Pathophysiology

Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this...
2
Increased Intracranial Pressure l: Introduction01:14

Increased Intracranial Pressure l: Introduction

Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component...
6
Hemorrhagic Stroke ll: Pathophysiology01:29

Hemorrhagic Stroke ll: Pathophysiology

A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
7
Increased Intracranial Pressure ll: Pathophysiology01:29

Increased Intracranial Pressure ll: Pathophysiology

Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins...
5
Cerebral Edema l: Introduction01:19

Cerebral Edema l: Introduction

Cerebral edema is a pathological increase in brain water content that disrupts intracranial pressure regulation and impairs neurological function. Because the cranial vault is rigid, even modest increases in tissue volume can compromise cerebral perfusion, distort neural structures, and initiate secondary injury. Cerebral edema develops through four principal mechanisms: vasogenic, cytotoxic, interstitial, and ionic.Vasogenic EdemaVasogenic edema arises from disruption of the blood–brain...
4
Anatomy of the Brain: Ventricles01:18

Anatomy of the Brain: Ventricles

There are hollow fluid-filled cavities known as ventricles deep inside the human brain. There are two lateral ventricles, one in each cerebral hemisphere, and each has three different projections — the anterior, inferior, and posterior horns visible from the lateral side. A thin membrane called the septum pellucidum separates the two lateral ventricles. The slender third ventricle in the diencephalon is connected to each lateral ventricle via a channel called the interventricular foramen.
10.1K