Abstract

The pathophysiology of cerebral dysfunction in normal pressure hydrocephalus (NPH) and the mechanism of clinical improvement in NPH patients who undergo cerebrospinal fluid (CSF) shunting are still unclear. The hypothesis of GREITZ (1) that cerebral circulation is adversely affected by “brain distension” in conditions like NPH and the reports of improvement of cerebral blood flow (CBF) concomittant with clinical improvement after CSF shunting (2,3,4) led us to study cerebral hemodynamics and their relationship to changes in cerebrospinal fluid pressure (CSFP) in patients with NPH and “hydrocephalus ex vacuo” due to cerebral atrophy. The primary aim of the study was to determine the existence of any abnormal cerebral hemodynamics in NPH and if so, to examine their implications in the treatment and prognosis.

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