Hostname: page-component-848d4c4894-x5gtn Total loading time: 0 Render date: 2024-05-13T22:39:38.264Z Has data issue: false hasContentIssue false
  • English
  • Français

Neuropathological Changes in Chronic Adult Hydrocephalus: Cortical Biopsies and Autopsy Findings

Published online by Cambridge University Press:  18 September 2015

Marc R. Del Bigio ,
Erico R. Cardoso  and
William C. Halliday
Marc R. Del Bigio*
Affiliation:
Department of Pathology, University of Manitoba and Health Sciences Centre, Winnipeg.
Erico R. Cardoso
Affiliation:
Department of Neurosurgery, Brookdale Hospital Medical Center, Brooklyn, NY.
William C. Halliday
Affiliation:
Department of Pathology, University of Manitoba and Health Sciences Centre, Winnipeg.
*
Department of Pathology, University of Manitoba, D212 - 770 Bannatyne Avenue, Winnipeg, Manitoba, Canada R3E 0W3
Rights & Permissions [Opens in a new window]

Abstract:

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Background:

The cortical changes resulting from chronic hydrocephalus in adults are not well defined.

Methods:

Retrospective analysis of twenty-one patients (age 64-88 years) with a clinical diagnosis of “normal pressure hydrocephalus” who underwent cortical biopsy at the time of intracranial pressure monitoring or shunt insertion, and eight patients who were biopsied but not shunted. Eleven brains (age 26-92 years), seven from patients who could be considered to have “normal pressure hydrocephalus”, were also examined following autopsy. Age- and sex-matched control brains with small ventricles and no history of dementia were compared to the hydrocephalic brains. Senile plaques and neurofibrillary tangles were assessed semiquantitatively and a non-parametric statistical analysis was employed.

Results:

Five biopsies exhibited both senile plaques and rare neurofibrillary tangles, while two had only neurofibrillary tangles. Neurofibrillary tangles were more prevalent in hydrocephalic brains than in controls. There was no difference in the prevalence of senile plaques between the two groups. Grumose bodies in the substantia nigra were identified in five autopsy brains, a prevalence higher than in control brains.

Conclusions:

These pathological features are not specific for hydrocephalus; however, they suggest that long-standing ventriculomegaly is associated with degenerative brain changes in sites beyond the periventricular white matter. The presence of senile plaques in cortical biopsies from hydrocephalic patients does not appear to be a contraindication to shunting; however a prospective study in patients undergoing intracranial pressure monitoring would better address the issue.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 24 , Issue 2 , May 1997 , pp. 121 - 126
Copyright
Copyright © Canadian Neurological Sciences Federation 1997

References

REFERENCES

1.Del Bigio, MR. Neuropathological changes caused by hydrocephalus. Acta Neuropathol 1993; 85: 573–585.CrossRefGoogle ScholarPubMed
2.Stein, SC, Langfitt, TW. Normal pressure hydrocephalus: predicting the results of cerebrospinal fluid shunting. J Neurosurg 1974; 41: 463–470.CrossRefGoogle ScholarPubMed
3.Torack, RM. Adult dementia: history, biopsy, pathology. Neurosurgery 1979; 4: 434–442.CrossRefGoogle ScholarPubMed
4.Tedeschi, E, Hasselbach, SG, Waldemar, G, et al. Heterogenous cerebral glucose metabolism in normal pressure hydrocephalus. J Neurol Neurosurg Psychiatry 1995; 59: 608–615.CrossRefGoogle ScholarPubMed
5.Wisniewski, HM, Popovitch, ER, Kaufman, MA, Wisniewski, KE. Neurofibrillary changes in advanced hydrocephalus. A clinicopathological study. J Neuropathol Exp Neurol 1987; 46: 340.CrossRefGoogle Scholar
6.Cardoso, ER, Piatek, D, Del Bigio, MR, Stambrook, M, Sutherland, JB. Quantification of abnormal intracranial pressure waves and isotope cisternography for diagnosis of occult communicating hydrocephalus. Surg Neurol 1989; 31: 20–27.CrossRefGoogle ScholarPubMed
7.Lamy, C, Duyckaerts, C, Delaere, P, et al. Comparison of seven staining methods for senile plaques and neurofibrillary tangles in a prospective series of 15 elderly patients. Neuropathol Appl Neurobiol 1989; 15: 563–578.CrossRefGoogle Scholar
8.Mirra, SS, Heyman, A, Mckee, D, et al. The Consortium to Establish a Registry for Alzheimer’s Disease (CERAD). Part II. Standardization of the neuropathologic assessment of Alzheimer’s disease. Neurology 1991; 41: 479–486.CrossRefGoogle Scholar
9.Kristensen, B, Malm, J, Fagerlund, M, et al. Regional cerebral blood flow, white matter abnormalities, and cerebrospinal fluid hydrodynamics in patients with idiopathic adult hydrocephalus syndrome. J Neurol Neurosurg Psychiatry 1996; 60: 282–288.CrossRefGoogle ScholarPubMed
10.Vanneste, JAL. Three decades of normal pressure hydrocephalus: are we wiser now? J Neurol Neurosug Psychiatry 1994; 57: 1021–1025.CrossRefGoogle ScholarPubMed
11.Bradley, WG, Whittemore, AR, Watanabe, AS, et al. Association of deep white matter infarction with chronic communicating hydrocephalus: implications regarding the possible origin of normalpressure hydrocephalus. Am J Neuroradiol 1991; 12: 31–39.Google ScholarPubMed
12.Earnest, MP, Fahn, S, Karp, JH, Rowland, LP. Normal pressure hydrocephalus and hypertensive cerebrovascular disease. Arch Neurol 1974; 31: 262–266.CrossRefGoogle ScholarPubMed
13.Krauss, JK, Regel, JP, Vach, W, et al. Vascular risk factors and arteriosclerotic disease in idiopathic normal-pressure hydrocephalus of the elderly. Stroke 1996; 27: 24–29.CrossRefGoogle ScholarPubMed
14.Newton, H, Pickard, JD, Weller, RO. Normal pressure hydrocephalus and cerebrovascular disease: findings of postmortem. J Neurosurg Psychiatry 1989; 52: 804.CrossRefGoogle ScholarPubMed
15.Deland, FH, James, AE, Ladd, DJ, Konigsmark, BW. Normal pressure hydrocephalus: a histologic study. Am J Clin Pathol 1972; 58: 58–63.CrossRefGoogle ScholarPubMed
16.Vessal, K, Sperber, EE, James, AE. Chronic communicating hydrocephalus with normal CSF pressures: a cisternographic-pathologic correlation. Ann Radiol (Paris) 1974; 17: 785–793.Google Scholar
17.Di Rocco, C, Di Trapani, G, Maira, G, et al. Anatomo-clinical correlations in normotensive hydrocephalus. Reports on three cases. J Neurol Sci 1977; 33: 437–452.CrossRefGoogle ScholarPubMed
18.Russell, DS. Observations on the pathology of hydrocephalus. Med Res Council Special Report Ser 1949; 265: 1–138.Google Scholar
19.Brusa, G, Piccardo, A, Pizio, N, Gambini, C. Anatomopathological study of dementia syndrome linked with an abnormal cerebrospinal fluid flow. Report of literature and personal observations. Pathologica 1991; 83: 351–358.Google ScholarPubMed
20.Graff-Radford, NR, Godersky, JC. Symptomatic congenital hydrocephalus in the elderly simulating normal pressure hydrocephalus. Neurology 1989; 39: 1596–1600.CrossRefGoogle ScholarPubMed
21.Fan, KJ, Pezeshkpour, G. Neurofibrillary tangles in association with congenital hydrocephalus. J Nat Med Assoc 1987; 79: 1001–1003,1006.Google ScholarPubMed
22.Chumas, PD, Drake, JM, Del Bigio, MR, Da Silva, M, Tuor, UI. Anaerobic glycolysis preceding white-matter destruction in experimental neonatal hydrocephalus. J Neurosurg 1994; 80: 491–501.CrossRefGoogle ScholarPubMed
23.Blass, JP, Gibson, GE. The role of oxidative abnormalies in the pathophysiology of Alzheimer’s disease. Rev Neurol 1991; 147: 513–525.Google Scholar
24.Mann, DMA, Brown, AMT, Prinja, D, Jones, D, Davies, CA. A morphological analysis of senile plaques in the brains of nondemented persons of different ages using silver, immunocytochemical and lectin histochemical staining techniques. Neuropathol Appl Neurobiol 1990; 16: 17–26.CrossRefGoogle ScholarPubMed
25.Ball, MJ, Neurofibrillary tangles in the dementia of “normal pressure” hydrocephalus. Can J Neurol Sci 1976; 3: 227–235.CrossRefGoogle ScholarPubMed
26.Ball, MJ, Vis, CL. Relationship of granulovacuolar degeneration in hippocampal neurones to aging and to dementia in normal-pressure hydrocephalus. J Gerontol 1978; 33: 815–824.CrossRefGoogle Scholar
27.Bret, P. L’hydrocephalie chronique de I’adulte. Neurochirurgie 1990; 36 Suppl 1: 1–159.Google Scholar
28.De Mol, J, Retif, J, Brihaye, J. Démence hydrocephalique et/ou dégénerative. Acta Neurol Belg 1989; 89: 228–235.Google ScholarPubMed
29.Wang, D, Munoz, DG. Qualitative and quantitative differences in senile plaque dystophic neurites of Alzheimer’s disease and normal aged brain. J Neuropathol Exp Neurol 1995; 54: 548–556.CrossRefGoogle Scholar
30.Gearing, M, Mirra, SS, Hedreen, JC, et al. The Consortium to Establish a Registry for Alzheimer’s Disease (CERAD). Part X. Neuropathology confirmation of the clinical diagnosis of Alzheimer’s disease. Neurology 1995; 45: 461–466.CrossRefGoogle Scholar
31.Popovitch, ER, Wisniewski, HM, Barcikowska, M, et al. Alzheimer neuropathology in non-Down’s syndrome mentally retarded adults. Acta Neuropathol 1990; 80: 362–367.CrossRefGoogle ScholarPubMed
32.Orton, ST. A pathological study of a case of internal hydrocephalus. Am J Insanity 1908; 65: 229–278.Google Scholar
33.Penfield, W. Notes on cerebral pressure atrophy. Res Publ Assoc Nerv Ment Dis 1929; 8: 246–362.Google Scholar
34.Pierce, LB. Aquired hydrocephalus. Report of two cases occurring in adults. Am J Psychiatr 1933; 12: 769–773.CrossRefGoogle Scholar
35.Yakovlev, PI. Paraplegias of hydrocephalus. (A clinical note and interpretation). Am J Mental Deficiency 1947; 51: 561–576.Google Scholar
36.Oppenheimer, DR, Esiri, MM. Diseases of the basal ganglia, cerebellum and motor neurons. In: Adams, JH, Duchen, LW, eds. Greenfield’s Neuropathology, 5th Edition. New York: Oxford University Press, 1992: 988–1045.Google Scholar
37.Wenning, G, Quinn, N. Are Lewy bodies non-specific epiphenomena of nigral damage? Mov Disord 1994; 9: 378–379.CrossRefGoogle ScholarPubMed
38.Arai, N, Yagishita, S, Amano, N, Iwabuchi, K, Misugi, K. “Grumose degeneration” of Tretiakoff. J Neurol Sci 1989; 94: 319–323.CrossRefGoogle ScholarPubMed
39.Arai, N. Grumose or foamy spheroid bodies involving astrocytes in the human brain – review. Neuropathol Appl Neurobiol 1995; 21: 238–245.CrossRefGoogle ScholarPubMed
40.Curran, T, Lang, AE. Parkinsonian syndromes associated with hydrocephalus: case reports, a review of the literature, and pathophysiological hypothesis. Mov Disord 1994; 9: 508–520.CrossRefGoogle Scholar