Normaldruckhydrozephalus

Zusammenfassung

Für Diagnostik, Differenzialdiagnostik und Differenzialtherapie des Normaldruckhydrozephalus ist die Bildgebung entscheidend. Auch wenn die Therapie eines Normaldruckhydrozephalus nicht erfolgreich sein sollte, werden zahlreiche Fragen an den Radiologen gestellt. Der Artikel gibt eine Übersicht über das Krankheitsbild des Normaldruckhydrozephalus und die speziellen prä- und postchirurgischen Anforderungen an die Bildgebung.

Abstract

Normal pressure hydrocephalus is a very common disease in elderly people. It is a progressive disease. Patients untreated end bedridden, mortality is significantly higher. Normal pressure hydrocephalus is characterized by gait disturbance, incontinence and cognitive impairment. Typically ventriculomegaly and discrepancy of large basal and tight high convexity subarachnoid spaces are shown on MRI or CCT. Imaging helps also in differential indication for surgical treatment: Ventriculo-peritoneal shunting or endoscopic third ventriculostomy. Surgery is most effective with low complication rates. Postoperative imaging is needed if clinical improvement is missing and helps to detect causes of shunt malfunction.

Kernaussagen

• Der Normaldruckhydrozephalus ist eine häufige Erkrankung des älteren Menschen, die ohne Behandlung in der Pflegebedürftigkeit endet.

• Die Diagnostik des NPH stützt sich auf 3 Hauptsäulen: Klinik, Bildgebung und liquordynamische Untersuchung.

• Die Bildgebung ist darüber hinaus entscheidend in der Therapiewahl: Shunt oder endoskopische Ventrikulozisternostomie.

• Die Behandlung ist für die Patienten und ihre Angehörige segensreich.

• Bei ausbleibendem Behandlungserfolg oder später erneut auftretender NPH-Symptomatik ist die Bildgebung von entscheidender Bedeutung in der Ursachenabklärung.

Schlüsselwörter

Normaldruckhydrozephalus - DESH - InfinoH - ventrikuloperitonealer Shunt - MRT - Gravitationsventil

Key words

normal pressure hydrocephalus - DESH - InfinoH - ventriculo-peritoneal shunt - MRI - hydrostatic valves

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