Computer analysis of periventricular lucency on the CT scan

Area of Science:

• Neurology
• Radiology
• Neurosurgery

Background:

• Periventricular lucency (PVL) is a finding in hydrocephalus.
• Understanding the pathogenesis of PVL is crucial for diagnosis and treatment.

Purpose of the Study:

• To investigate the causes and pathogenesis of periventricular lucency (PVL) in patients with hydrocephalus.
• To clarify the relationship between PVL, hydrocephalus type, and ventricular size.

Main Methods:

• Analysis of 53 patients with periventricular lucency.
• Categorization of hydrocephalus into obstructive and communicating types.
• Correlation of PVL with tumor presence, subarachnoid hemorrhage, and hypertension.
• Experimental induction of obstructive hydrocephalus.
• Computer analysis for objective PVL display.

Main Results:

• 70% of patients with PVL had obstructive hydrocephalus (often from infratentorial tumors).
• 95% of patients with PVL had hypertensive hydrocephalus; 60% had slightly dilated ventricles.
• PVL was observed in the acute hypertensive stage of experimentally induced obstructive hydrocephalus.

Conclusions:

• PVL in hydrocephalus is frequently associated with obstructive causes and hypertension.
• The pathogenesis of PVL may involve passive diffusion or extravasation of cerebrospinal fluid (CSF) into white matter via a disrupted ventricular wall.
• This contrasts with the traditional theory of transependymal absorption of CSF.