Multi-modal MRI in normal pressure hydrocephalus identifies pre-operative haemodynamic and diffusion coefficient changes in normal appearing white matter correlating with surgical outcome

Abstract Magnetic resonance techniques were used to investigate haemodynamic abnormalities and their consequences in normal pressure hydrocephalus (NPH) and to assess changes in these parameters following surgery. Eleven patients with NPH were studied pre- and post-operatively using perfusion and diffusion weighted imaging and compared with ten age-matched controls. Pre-operative periventricular relative cerebral blood volume (rCBV) was reduced in patients (0.76±0.11) compared with control (1.16±0.16, P −3 mm 2 s −1 ) compared with both controls (1.04±0.4×10 −3 mm 2 s −1 , P −3 mm 2 s −1 , P P −3 mm 2 s −1 , P