engleski

Neuroradiology of CSF volume and movement impairments

Development of advanced radiological techniques make possible to depict central nervous system in details, with excellent contrast between CSF and surrounding structures (bones and parenchyma). Therefore, it is feasible to perform precise segmentation of all CSF spaces and to quantify their volumes both in intracranial and spinal part. Aside from volumetric analysis advanced MR techniques (T2 space and phase-contrast sequences) are capable to depict and even quantify movement of CSF, especially in regions where these movements are pronounced as foramen of Monro, mesencephalic aqueduct and cranio-cervical junction. Radiological diagnostic procedures often show findings which are not in concordance with classical CSF hypothesis based on active secretion manly by choroidal plexuses, unidirectional CSF circulation and reabsorption in dural sinuses. Our clinical cases showed that choroidal plexuses are not necessary for CSF production and that blockage of mesencephalic aqueduct will not always induce hypertensive hydrocephalus as proposed by classical concept. Furthermore, application of contrast in spinal CSF space will almost always show distribution opposite to one proposed by classical concept. These radiological findings point out that classical hypothesis of CSF physiology is not able to explain numerous clinical cases which emphasize necessity for new approaches to this issues.

cerebrospinal fluid , neuroimaging, fluid dinamic

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