Value of MRI CSF Flowmetry in Assessment of Grey Zone Hydrocephalic Patients

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Brief Title

Value of MRI CSF Flowmetry in Assessment of Grey Zone Hydrocephalic Patients

Official Title

Value of MRI CSF Flowmetry in Assessment of Grey Zone Hydrocephalic Patients

Brief Summary

      To evaluate accuracy of (MRI) cerebrospinal fluid flowmetry after shunt operation in patients
      with borderline (grey zone) hydrocephalus.

Detailed Description

      Hydrocephalus could be defined as disturbance of formation, flow or absorption of CSF. We
      encounter some challenging cases with intermittent non specific symptoms as delayed
      milestones and headache with concomitant imaging showing dilated ventricular system, so we
      find ourselves hesitating to take the decision of surgical intervention to put shunt or not,
      therefore MRI CSF flowmetry gives us a chance to overcome this problem. Phase contrast MR
      imaging is a rapid, simple and non-invasive technique which is sensitive to even small CSF
      flows, and can be used to evaluate CSF flow both qualitatively and quantitatively.

      CSF flow measurement at the suspected level of obstruction gives reliable and reproducible
      results for more accurate diagnosis and can be used to guide therapeutic decisions in a more
      reliable manner, and follow up post treatment outcome.

      With the CT and magnetic resonance imaging (MRI) techniques, it is possible to localize with
      accuracy the exact site of blockage of flow to CSF. Hence classification is as follows: The
      hydrocephalus may be due to 1) overproduction of CSF 2) obstructive 3) absorption defect.
      Depending on the exact aetiology, a secondary classification could be added under the
      following headings: 1) congenital, 2) acquired, eg; traumatic inflammatory, neoplastic, and
      degenerative . Bypassing the site of obstruction to CSF flow by diverting the CSF from
      ventricular cavity to a site where it is readily absorbed is the basic principle underlying
      the treatment of hydrocephalus. Extensive range of complications has been reported for
      shunting for hydrocephalus. They could be classified as mechanical or flow-related
      complications as CSF over drainage leading to subdural hematoma, subdural collections,
      low-pressure headaches cranial deformity, and asymmetrical drainage can lead to trapping or
      isolation of a part of a ventricular system. The slit ventricular syndrome is a complication
      related to absorption. Besides, ascites, loculations, hydrocele, perforation of the stomach,
      large and small bowel are also described. The success rates of shunt operation for
      hydrocephalus depend on the age of the patient and the reason why the shunt is needed.
      Generally, there is around a 50% failure rate for ventriculoperitoneal shunts.

Study Type


Primary Outcome

Decompressive changes in CT brain




MR CSF flowmetry

Study Arms / Comparison Groups

 grey zone hydrocephalic patients
Description:  MR CSF flowmetry CT brain Ventriculoperitoneal shunt


* Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline.

Recruitment Information

Recruitment Status


Estimated Enrollment


Start Date

August 2019

Completion Date

March 2021

Primary Completion Date

August 2020

Eligibility Criteria

        Inclusion Criteria:

        Patients with borderline hydrocephalus

          -  Clinically:suspicious and non specific symptoms as

               -  Headache

               -  Macrocranium

               -  Vomiting

               -  Gait instability

               -  Dementia

               -  Urine incontinence.

               -  delayed milestone.

          -  Radiologicaly: dilated ventricular system.

        Exclusion Criteria:

          -  Documented or clinically and radiologically evident cases of hydrocephalus

          -  Patients known to have contraindications for MRI, e.g. an implanted magnetic device,
             pacemakers or claustrophobia.




N/A - N/A

Accepts Healthy Volunteers



Mohammad Taghyan, 01005663647, [email protected]

Administrative Informations



Organization ID

grey zone hydrocephalus

Responsible Party

Principal Investigator

Study Sponsor

Assiut University

Study Sponsor

Mohammad Taghyan, Study Chair, professor

Verification Date

August 2019