Unusual Patient with Multiple Sclerosis and Shunt-Responsive Normal-Pressure Hydrocephalus

Algın, Oktay; Taşkapılıoğlu, Özlem; Hakyemez, Bahattin; Parlak, Müfıt

doi:10.1007/s00062-011-0068-3

Cited by 2 publications

(1 citation statement)

References 12 publications

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“…The absolute compliance in NPH is much lower than MS and the intracranial pulse pressure is probably higher but there may be a few patients who present with both conditions. There have been a few isolated case reports of patients with MS who had shunt responsive hydrocephalus [ 54 , 55 ]. It is likely that more patients exist but they may be misinterpreted as atrophy rather than NPH.…”

Section: Discussionmentioning

confidence: 99%

A comparison between the pathophysiology of multiple sclerosis and normal pressure hydrocephalus: is pulse wave encephalopathy a component of MS?

Bateman

Lechner‐Scott

Lea

2016

Fluids Barriers CNS

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BackgroundIt has been suggested there is a chronic neurodegenerative disorder, underlying the pathophysiology of multiple sclerosis (MS), which is distinct from the more obvious immune-mediated attack on the white matter. Limited data exists indicating there is an alteration in pulse wave propagation within the craniospinal cavity in MS, similar to the findings in normal pressure hydrocephalus (NPH). It is hypothesized MS may harbor pulse wave encephalopathy. The purpose of this study is to compare blood flow and pulse wave measurements in MS patients with a cohort of NPH patients and control subjects, to test this hypothesis.MethodsTwenty patients with MS underwent magnetic resonance (MR) flow quantification techniques. Mean blood flow and stroke volume were measured in the arterial inflow and venous out flow from the sagittal (SSS) and straight sinus (ST). The arteriovenous delay (AVD) was defined. The results were compared with both age-matched controls and NPH patients.ResultsIn MS there was a 35 % reduction in arteriovenous delay and a 5 % reduction in the percentage of the arterial inflow returning via the sagittal sinus compared to age matched controls. There was an alteration in pulse wave propagation, with a 26 % increase in arterial stroke volume but 30 % reduction in SSS and ST stroke volume. The AVD and blood flow changes were in the same direction to those of NPH patients.ConclusionsThere are blood flow and pulsation propagation changes in MS patients which are similar to those of NPH patients. The findings would be consistent with an underlying pulse wave encephalopathy component in MS.Electronic supplementary materialThe online version of this article (doi:10.1186/s12987-016-0041-2) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

A comparison between the pathophysiology of multiple sclerosis and normal pressure hydrocephalus: is pulse wave encephalopathy a component of MS?

Bateman

Lechner‐Scott

Lea

2016

Fluids Barriers CNS

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The Role of the Craniocervical Junction in Craniospinal Hydrodynamics and Neurodegenerative Conditions

Flanagan

2015

Neurology Research International

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The craniocervical junction (CCJ) is a potential choke point for craniospinal hydrodynamics and may play a causative or contributory role in the pathogenesis and progression of neurodegenerative diseases such as Alzheimer's disease, Parkinson's disease, MS, and ALS, as well as many other neurological conditions including hydrocephalus, idiopathic intracranial hypertension, migraines, seizures, silent-strokes, affective disorders, schizophrenia, and psychosis. The purpose of this paper is to provide an overview of the critical role of the CCJ in craniospinal hydrodynamics and to stimulate further research that may lead to new approaches for the prevention and treatment of the above neurodegenerative and neurological conditions.

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Unusual Patient with Multiple Sclerosis and Shunt-Responsive Normal-Pressure Hydrocephalus

Cited by 2 publications

References 12 publications

A comparison between the pathophysiology of multiple sclerosis and normal pressure hydrocephalus: is pulse wave encephalopathy a component of MS?

A comparison between the pathophysiology of multiple sclerosis and normal pressure hydrocephalus: is pulse wave encephalopathy a component of MS?

The Role of the Craniocervical Junction in Craniospinal Hydrodynamics and Neurodegenerative Conditions

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