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Case Report ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Neurol. | doi: 10.3389/fneur.2019.00262

Susceptibility Weighted Imaging (SWI) Recommended as a Regular Magnetic Resonance Diagnosis for Vascular Dementia to Identify independent Idiopathic Normal Pressure Hydrocephalus before Ventriculo-Peritoneal (V-P) Shunt Treatment: A Case Study

 Qing Lin1, 2*, Wen-Qing Huang3, Hui-Nuan Lin3 and  Chi-Meng Tzeng3*
  • 1Department of Neurology and Center for Brain Research, the First Affiliated Hospital of Xiamen University, China
  • 2Medical College of Xiamen University, China
  • 3School of Pharmaceutical Sciences, Xiamen University, China

Idiopathic normal pressure hydrocephalus (INPH) with comorbid vascular dementia (VD) often have poor response to ventriculo-peritoneal (V-P) shunt. Here, three patients over the age of 60 came to the hospital with the similar clinical symptoms, Evan index over 0.3, mini-mental state examination (MMSE) score less than 27, and cerebrospinal fluid (CSF) pressure under 200 mmH2O. They accepted conventional brain imaging scanning, followed by magnetic resonance-susceptibility weighted imaging (MR-SWI) scanning. We found that MR-SWI could distinguish INPH from leukoaraiosis (LA) and cerebral amyloid angiopathy (CAA), through cerebral microbleed (CMB) images, sharply. We highly recommended incorporation of MR-SWI into INPH international guidance as a routine pre-operative diagnostic method preceding V-P shunt treatment.

Keywords: Susceptibility weighted imaging (SWI), Idiopathic normal pressure hydrocephalus (iNPH), Vascular dementia (VD), Leukoaraiosis (LA), Cerebral Amyloid Angiopathy (CAA)

Received: 11 Aug 2018; Accepted: 27 Feb 2019.

Edited by:

Itamar Ronen, Leiden University, Netherlands

Reviewed by:

Ronald Peeters, University Hospitals Leuven, Belgium
Xiong Zhang, Wenzhou Medical University, China  

Copyright: © 2019 Lin, Huang, Lin and Tzeng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Dr. Qing Lin, Department of Neurology and Center for Brain Research, the First Affiliated Hospital of Xiamen University, Xiamen, 361001, Fujian Province, China, linqing2005602@aliyun.com
Prof. Chi-Meng Tzeng, School of Pharmaceutical Sciences, Xiamen University, Xiamen, 361102, Fujian Province, China, cmtzeng@xmu.edu.cn