تركز هذه الحلقة على الاستسقاء الدماغي ذو الضغط الطبيعي (iNPH)، مع تسليط الضوء على أساليب التشخيص، خيارات العلاج، وأحدث الأبحاث.

Chapters

00:00 مقدمة حول ضغط الدماغ الطبيعي

02:46 أسباب وأعراض ضغط الدماغ الطبيعي

05:54 تشخيص ضغط الدماغ الطبيعي وعلاقته بالأمراض الأخرى

08:54 علاج ضغط الدماغ الطبيعي وطرق التدخل الجراحي

This episode explores a quick review of idiopathic normal pressure hydrocephalus (iNPH), focusing on diagnostic methods, treatment options, and ongoing research.

Evan's Index and the Callosal Angle are two important radiological measurements used in the evaluation of normal pressure hydrocephalus (NPH). Here's how to measure each:

1. Evan's Index:

This index is a ratio that evaluates ventricular enlargement in relation to the cranial width.

Steps to Measure:

1. Image Type: Use an axial CT or T1/T2-weighted MRI slice at the level of the frontal horns of the lateral ventricles.

2. Measurements:

3. • Measure the maximal diameter of the frontal horns (inner width of the lateral ventricles) on the axial image.

   • Measure the widest diameter of the inner skull at the same level.

4. Calculation:

5. • Evan’s Index = (Frontal horn width) / (BPD or biparietal diameter, but from the inner table of the skull)

6. Interpretation:

7. • A value >0.3 suggests ventricular enlargement, which is consistent with hydrocephalus.

2. Callosal Angle:

This angle is measured to assess the morphology of the ventricles and the degree of corpus callosum bowing.

Steps to Measure:

1. Image Type: Use a coronal MRI slice obtained perpendicular to the anterior commissure–posterior commissure (AC-PC) plane and through the posterior part of the lateral ventricles (typically at the level of the posterior commissure).

2. Measurements:

3. • Identify the superior aspect of the lateral ventricles where the corpus callosum arches above.

   • Draw two lines along the medial borders of the lateral ventricles.

4. Angle Measurement:

5. • Measure the angle formed at the point where the two lines converge, which corresponds to the callosal arch, usually the system will measure the angle via a tool.

6. Interpretation:

7. • A normal callosal angle is typically 100–120°.

   • In NPH, this angle is reduced, often falling below 90° due to lateral ventricular dilation.

Both measures are key components in diagnosing NPH, but they should always be interpreted in conjunction with clinical findings, patient history, and other imaging features.

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Keywords

#normalpressurehydrocephalus, #NPH, #Neurosurgery, #neurolneurology

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