Volumetric analysis of cerebrospinal fluid and brain parenchyma in a patient with hydranencephaly and macrocephaly - case report

Radoš, Milan and Klarica, Marijan and Mučić-Pucić, Branka and Nikić, Ines and Raguž, Marina and Galkowski, Valentina and Mandić, Dora and Orešković, Darko (2014) Volumetric analysis of cerebrospinal fluid and brain parenchyma in a patient with hydranencephaly and macrocephaly - case report. Croatian Medical Journal, 55 (4). pp. 388-393. ISSN 0353-9504

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The aim of this study was to perform for the first time the intracranial volumetric analysis of cerebrospinal fluid (CSF) and brain parenchyma in the supratentorial and infratentorial space in a 30-year-old female patient with hydranencephaly and macrocephaly. A head scan performed using a 3T magnetic resonance was followed by manual segmentation of the brain parenchyma and CSF on T2 coronal brain sections. The volume of CSF and brain parenchyma was measured separately for the supratentorial and infratentorial space. The total volume of the intracranial space was 3645.5 cm(3). In the supratentorial space, the volume of CSF was 3375.2 cm(3) and the volume of brain parenchyma was 80.3 cm(3). In the infratentorial space, the volume of CSF was 101.3 cm(3) and the volume of the brain parenchyma was 88.7 cm(3). In the supratentorial space, there was severe malacia of almost all brain parenchyma with no visible remnants of the choroid plexuses. Infratentorial structures of the brainstem and cerebellum were hypoplastic but completely developed. Since our patient had no choroid plexuses in the supratentorial space and no obstruction between dural sinuses and CSF, development of hydrocephalus and macrocephaly cannot be explained by the classic hypothesis of CSF physiology with secretion, unidirectional circulation, and absorption as its basic postulates. However, the origin and turnover of the enormous amount of intracranial CSF volume, at least 10-fold larger than normal, and the mechanisms of macroencephaly development could be elucidated by the new hypothesis of CSF physiology recently published by our research team.

Item Type: Article
MeSH: Adult ; Brain / pathology ; Brain / physiopathology ; Female ; Humans ; Hydranencephaly / cerebrospinal fluid ; Hydranencephaly / complications ; Magnetic Resonance Imaging ; Megalencephaly / cerebrospinal fluid ; Megalencephaly / complications ; Persistent Vegetative State / cerebrospinal fluid ; Persistent Vegetative State / etiology
Departments: Hrvatski institut za istraživanje mozga
Katedra za farmakologiju
Depositing User: Marijan Šember
Status: Published
Klarica, MarijanUNSPECIFIED
Mučić-Pucić, BrankaUNSPECIFIED
Galkowski, ValentinaUNSPECIFIED
Orešković, DarkoUNSPECIFIED
Date: 28 August 2014
Date Deposited: 01 Oct 2014 08:12
Last Modified: 17 Jul 2020 10:25
Subjects: /
Related URLs:
URI: http://medlib.mef.hr/id/eprint/2156

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