71 year old male patient with the clinical triad of normal pressure hydrocephalus, dementia, gait disturbance and urinary incontinence.
Suboccipital  puncture was done  injecting 12 mCi of Tc99m DTPA.
Note symmetric activity in both lateral ventricles  at 2h (top) persisting at 24 h (bottom). Incomplete circulation to reabsorption sites in the Pacchioni bodies at 24 h.

Radiocisternography is an excelent procedure to study CSF circulation. A ventriculo-peritoneal device is indicated if ventricular reflux and no proper CSF circulation is demonstrated.
 

1 Chmielowski K, Podgórski JK, Twarkowski P, Pietrzykowski J, Szaluś N.Radionuclide cisternography in the diagnosis of normal
pressure hydrocephalus. Pol Merkur Lekarski. 2004 Jun;16(96):576-80.

2 Thom AF et al. Medicina Nuclear en la Hidrocefalia del Adulto, p: 491-497 in: Medicina Nuclear Aplicaciones Clínicas. Eds: I. Carrio - P. González. Editorial Masson, Barcelona España, 2003.


 

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