[Decompensation of chronic internal hydrocephalus in an adult patient]. / Dekompensatsiya khronicheskoi vnutrennei gidrotsefalii u vzroslogo patsienta. Sluchai iz praktiki i obzor literatury.

We report a rare case of decompensated chronic internal hydrocephalus in an adult patient. A 35-year-old woman experienced acute intracranial hypertension in 3 weeks after relief of postoperative inflammation in the oral cavity (tooth extraction). MRI revealed severe internal hydrocephalus. Third ventriculostomy was followed by significant clinical improvement. However, postoperative survey and subsequent neuroimaging confirmed no reduction of ventricular system. Thus, decompensation of chronic hydrocephalus following dental intervention and subsequent oral inflammation was assumed. Impaired venous outflow from the brain and destabilization of CSF circulation can be considered as a pathogenetic mechanism.

[Use of phase-contrast magnetic resonance imaging to quantify cerebrospinal fluid dynamics in patients with communicating hydrocephalus].

OBJECTIVE: to determine differences in cerebrospinal fluid (CSF) flow velocities in patients with varying degrees of communicating hydrocephalus (CH) versus a group of healthy volunteers without hydrodynamic disorders. MATERIAL AND METHODS: The investigation enrolled 27 CH patients (17 and 10 patients with an Evans index of 0.31 and 0.46, respectively) and 62 healthy volunteers. Average, volumetric, and peak flow velocities were determined at different intracranial levels. RESULTS: Analysis of differences between the mean values indicated that the patients with CH were observed to have progressive cranial cavity CSF outflow obstruction that depended on the degree of dilation of the ventricular system and, probably, on impaired CSF reabsorption. These changes can provide an explanation for the clinical symptoms present in the patients and also serve as diagnostic criteria. CONCLUSION: The investigation showed that phase-contrast magnetic resonance imaging might be used to estimate the quantitative indicators of CSF in health and in varying degrees of CH. The velocity characteristics of antegrade and retrograde CSF flows are significantly different in health and in disease, which may be relevant to neurologists and neurosurgeons when planning therapy and surgery options.