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Related Experiment Videos

Normal pressure hydrocephalus. Neuropathological study.

K Akai, S Uchigasaki, U Tanaka

    Acta Pathologica Japonica
    |January 1, 1987
    PubMed
    Summary

    Brain demyelination and arteriosclerosis are key pathological changes in normal pressure hydrocephalus (NPH). White matter degeneration, not just ventricle enlargement, plays a crucial role in NPH development.

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    Area of Science:

    • Neuropathology
    • Vascular Neurology

    Background:

    • Normal pressure hydrocephalus (NPH) is a clinical syndrome characterized by gait disturbance, urinary incontinence, and cognitive impairment.
    • The exact pathological mechanisms underlying NPH remain incompletely understood.

    Purpose of the Study:

    • To describe the pathological brain changes in patients diagnosed with NPH.
    • To discuss potential etiological mechanisms contributing to NPH development.

    Main Methods:

    • Post-mortem examination of brain tissue from seven patients clinically diagnosed with NPH.
    • Histopathological analysis focusing on white matter, vasculature, and meninges.

    Main Results:

    • Consistent findings of demyelination, particularly in frontal lobes, resembling Binswanger's encephalopathy.
    • Evidence of arteriosclerosis, periventricular white matter microinfarcts, thrombi, leptomeningeal fibrosis, and diminished arachnoidal granulations.
    • Significant degeneration of both periventricular and deep white matter with microinfarcts and moderate to severe arteriosclerosis.

    Conclusions:

    • White matter degeneration, including microinfarcts and arteriosclerosis, is a critical pathological feature in NPH.
    • This degeneration is likely not solely secondary to ventricular enlargement but plays a primary role in NPH pathogenesis.
    • NPH development involves both cerebrospinal fluid disturbances and pre-existing white matter vulnerability due to factors like ischemia and hypoxia.

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