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Related Experiment Videos

Abnormal cisternogram associated with Diamox therapy.

N Papanicolaou, B J McNeil, H H Funkenstein

    Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine
    |May 1, 1978
    PubMed
    Summary

    Diamox (acetazolamide) can mimic normal-pressure hydrocephalus on cisternograms by reducing cerebrospinal fluid production. Discontinuing the medication normalized the imaging results, suggesting a reversible drug-induced effect.

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    Area of Science:

    • Neurology
    • Nephrology
    • Pharmacology

    Background:

    • Normal-pressure hydrocephalus (NPH) is a neurological disorder characterized by enlarged ventricles and gait disturbance, urinary incontinence, and dementia.
    • Cisternography is an imaging technique used to evaluate cerebrospinal fluid (CSF) flow and diagnose conditions like NPH.

    Observation:

    • A patient undergoing evaluation for rapid mental deterioration presented with a cisternogram suggestive of NPH while taking Diamox (acetazolamide).
    • Subsequent cisternography after discontinuing Diamox showed near-normal results.

    Findings:

    • The initial abnormal cisternogram is hypothesized to be a false positive caused by Diamox.
    • Diamox, a carbonic anhydrase inhibitor, likely reduced CSF production, leading to tracer reflux into the ventricles.

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  • This reflux is attributed to a reduction in the bulk flow of CSF from the ventricles.

    • Implications:

    • Carbonic anhydrase inhibitors like Diamox may induce imaging findings mimicking NPH.
    • Discontinuation of Diamox can reverse these abnormal cisternogram findings.
    • This highlights the importance of medication history in interpreting neuroimaging studies for hydrocephalus.