Cerebrospinal fluid imaging using serial metrizamide CT cisternography

Abstract

Twenty-five patients studied by serial metrizamide (Amipaque) CT cisternography were used to analyze CSF kinetics. Delayed CSF flow patterns were noted in 7 patients, while intermediate patterns occurred in 4. The abnormal cisternogram was characterized primarily by ventricular reflux and stasis and secondarily by diminution of the parasagittal blush and a periventricular rim of decreased absorption. The intermediate group had minimal ventricular stasis after 24 hours and a normal parasagittal blush. After clinical and biochemical evaluation of the patient with dementia, CT scanning is usually indicated. If a profile suggestive of communicating hydrocephalus emerges, CSF kinetics can be monitored dynamically by CT scanning with metrizamide enhancement.

Electroencephalographic Changes in Pediatric Patients following Metrizamide Cisternography

“…16. 17] and following CT cisternography [1,2], These changes have been significantly less when compared to those reported for other water-soluble media such as methiodal and meglumine iocarmate which is possibly related to metrizamide's nondissociable substance. The EEG abnormalities have consisted of bifrontal synchronous slow waves of 1-3 Hz.…”

“…Kaada [13] has postulated that the slow waves arise from diencephalic structures and do not represent cortical irritation. The delayed onset of the EEG changes suggests that they are related to the entry of the contrast media into the brain (CT 'cerebral blush') rather than to the maximum concentration in the subarachnoid spaces [1,2], since even complex hydrophilic macro molecules may readily cross the CSF brain barrier. Within 24 h, most of the iodinated contrast has cleared from the subarachnoid spaces and adja cent brain.…”

Response of cerebral blood flow and cerebrovascular reactivity to acetazolamide in patients with dementia and idiopathic normal-pressure hydrocephalus

“…Evidence of ventricular stasis for more than 24 hours and/or persistent cerebral blush for more than 48 hours was considered abnormal. [5] Magnetic resonance (MR) imaging demonstrated various degrees of white matter lesions in all patients, but no stenosis or obstruction of the main cerebral arteries was detected on MR angiography . Patients with ventricuomegaly of known cause, such as subarachnoid hemorrhage, intraventriclular hemorrhage, trauma, brain tumor, and meningitis, were not included in the present study.…”

Cerebrospinal fluid physiology: visualization of cerebrospinal fluid dynamics using the magnetic resonance imaging Time-Spatial Inversion Pulse method

“…Actually, it was previously thought that this type of CSF flow does not occur in healthy persons (12), but only in patients with hydrocephalus, who have impaired CSF circulation (13-15). This was based on the finding that when contrast medium or radioisotope (RI) is injected into the CSF in the lumbar subarachnoid space in patients with hydrocephalus, the CSF is seen to flow back into the lateral ventricles.…”

“…This was based on the finding that when contrast medium or radioisotope (RI) is injected into the CSF in the lumbar subarachnoid space in patients with hydrocephalus, the CSF is seen to flow back into the lateral ventricles. This finding, which is called ventricular reflux of the CSF, has been used to confirm the diagnosis of hydrocephalus (13-15) (Figure 3A). …”