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Related Concept Videos

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 expands, CSF and venous blood...
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 with...
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...
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 barrier loses...

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Characterizing Multiscale Mechanical Properties of Brain Tissue Using Atomic Force Microscopy, Impact Indentation, and Rheometry
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MR Elastography Demonstrates Increased Brain Stiffness in Normal Pressure Hydrocephalus.

N Fattahi1, A Arani1, A Perry1

  • 1From the Department of Radiology, Mayo Clinic, Rochester, Minnesota.

AJNR. American Journal of Neuroradiology
|November 7, 2015
PubMed
Summary

Normal pressure hydrocephalus (NPH) shows increased brain stiffness in key areas. MR elastography may help diagnose NPH and assess shunt therapy effectiveness.

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Area of Science:

  • Neurology
  • Medical Imaging
  • Biophysics

Background:

  • Normal pressure hydrocephalus (NPH) presents with cognitive impairment, gait issues, and incontinence.
  • Differentiating NPH from other dementias is challenging due to overlapping symptoms.
  • Improved diagnostic tools are crucial for effective NPH patient management.

Purpose of the Study:

  • To evaluate brain stiffness in NPH patients using MR elastography.
  • To compare brain stiffness between NPH patients and healthy controls.

Main Methods:

  • MR elastography was performed on 10 NPH patients and 21 healthy volunteers.
  • A 3T MR scanner and a passive driver transmitted 60-Hz shear waves into the brain.
  • A novel postprocessing technique determined regional brain stiffness; statistical analysis used Wilcoxon rank sum test and linear regression.

Main Results:

  • NPH patients exhibited significantly increased stiffness in the cerebrum, occipital, parietal, and temporal lobes compared to controls.
  • No significant stiffness differences were found in the frontal lobe, deep gray/white matter, or cerebellum.
  • P-values indicated statistical significance for affected regions (e.g., P = .001 for cerebrum).

Conclusions:

  • This study confirms increased brain stiffness in NPH patients.
  • Findings support MR elastography as a potential diagnostic tool for NPH.
  • Further research is warranted to explore MR elastography's role in NPH diagnosis and shunt therapy efficacy.