The role of Magnetic Resonance Imaging CSF Flowmetry in Differentiating between Normal Pressure Hydrocephalus and Involutional Brain Changes

Background: Cerebrospinal fluid (CSF) is a 10% intracranial fluid that encloses the brain and spinal cord, filling the spaces between them. Aim: To determine the utility of PC-MRI CSF flowmetry in distinguishing between normal pressure hydrocephalus (NPH) and involutional brain alterations. Patients and methods: This was cross-sectional research that was performed upon 20 cases referred from the neurology and neurosurgery departments, Al-Zahraa University Hospital, to the Magnetic resonance imaging (MRI) unit of the Radiology Department, Al-Zahraa University Hospital in Cairo, Egypt, throughout the period of the study between April 2023 and April 2024. Results: A statistically insignificant variance has been observed among NPH compared to involutional brain changes according to conventional MRI findings, with a p-value (p>0.05). There was statistically significant greater mean value of end diastolic peak velocity "PDV" (cm/s); systolic peak velocity" PSV" (cm/s); peak diastolic flow "PDF" (ml/s); peak systolic flow "PSF" (ml/s); mean systolic flow (ml/s) and systolic SV (µl/s) in NPH comparing to involutional brain changes, with p-value (p<0.05). Conclusion: PC-Magnetic Resonance Imaging Cerebrospinal fluid flowmetry provides an easy, fast, and non-invasive technique for diagnosing and following up patients with normal pressure hydrocephalus and brain atrophy. Furthermore, it contributes to the total accuracy of conventional magnetic resonance imaging investigations because it can distinguish between NPH and brain atrophy. It can also be used for pre-operative prediction of cases most responsive to VP shunt and ETV, as well as assessment of VP shunt patency.