RIHSA cisternography in cerebral tumours.

Area of Science:

• Neurology
• Neurosurgery
• Radiology

Background:

• Supratentorial tumors can lead to increased intracranial pressure.
• Cerebrospinal fluid (CSF) dynamics are crucial for maintaining normal intracranial pressure.
• Understanding CSF flow disturbances is vital for managing brain tumors.

Purpose of the Study:

• To evaluate cerebrospinal fluid (CSF) flow patterns in patients with supratentorial tumors using Radioactive Iodine-125 labeled Human Serum Albumin (RIHSA) cisternography.
• To identify common sites of CSF obstruction associated with supratentorial tumors.
• To explore the relationship between CSF flow disturbances and the pathogenesis of raised CSF pressure in these patients.

Main Methods:

• RIHSA cisternography was performed on 24 patients diagnosed with supratentorial tumors.
• Analysis focused on identifying abnormalities in CSF circulation pathways.
• Specific attention was given to the sylvian fissure, subarachnoid space, tentorial notch, and superior sagittal sinus.

Main Results:

• All 24 patients exhibited abnormal RIHSA cisternography findings.
• The most frequent abnormality was asymmetry due to ipsilateral obstruction of the sylvian fissure and surrounding subarachnoid space.
• Partial or complete obstruction at the tentorial notch, often with reduced superior sagittal sinus activity, was also commonly observed.

Conclusions:

• RIHSA cisternography is a sensitive method for detecting CSF flow abnormalities in supratentorial tumors.
• Obstructed CSF pathways, particularly at the sylvian fissure and tentorial notch, are characteristic findings.
• These CSF flow disturbances likely contribute significantly to the development of raised CSF pressure in patients with cerebral tumors.