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61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010
Joint Meeting mit der Brasilianischen Gesellschaft für Neurochirurgie am 20. September 2010

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

21. - 25.09.2010, Mannheim

Evaluating volumetric MRI quantification of the olfactory bulb as an independent factor correlating the outcome of idiopathic normal pressure hydrocephalus after shunt implantation

Meeting Abstract

  • Dino Podlesek - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Carl-Gustav-Carus, Dresden, Deutschland
  • Johannes Gerber - Abteilung Neuroradiologie, Universitätsklinikum Carl-Gustav-Carus, Dresden, Deutschland
  • Gabriele Schackert - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Carl-Gustav-Carus, Dresden, Deutschland
  • Matthias Kirsch - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Carl-Gustav-Carus, Dresden, Deutschland
  • Thomas Hummel - Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Arbeitsbereich „Riechen und Schmecken“, Universitätsklinikum Carl-Gustav-Carus Dresden, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010. Mannheim, 21.-25.09.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocP1778

DOI: 10.3205/10dgnc249, URN: urn:nbn:de:0183-10dgnc2492

Veröffentlicht: 16. September 2010

© 2010 Podlesek et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: The cardinal symptoms of idiopathic normal pressure hydrocephalus (iNPH) are gait disturbance, dementia and incontinence. An important pathological feature is dysfunctional CSF dynamics. Examination of the CSF has shown the neuronal degeneration in patients with iNPH. Surgical treatment is usually the implantation of a ventriculo-peritoneal shunt (VPS) system. Ventricle size does not necessarily correlate with clinical improvement after shunting. The purpose of the present study is to evaluate the olfactory bulb (OB) volume as an indicator of neuronal affection in iNPH.

Methods: The prospective study includes 24 patients with iNPH (9 women and 15 men, mean age=68 y). Two patients. suffered from obstructive HCP secondary to aqueduct stenosis. A group of otherwise healthy controls included 7 women and 10 men (mean age of 61y). Comprehensive assessment of olfactory function was performed with the "Sniffin’ Sticks" test kit. Cranial MRI and sniffing tests were performed before and three months after operative treatment of the hydrocephalus via VPS. However, due to decreased patients’ compliance, postoperative evaluation of the olfactory function was performed in only 10 patients. OB volume was measured by coronal t2-weighted MR images with a slice thickness of 2 mm.

Results: Pre- and postoperative measurements of the olfactory bulb could be completed in 15 pts. Preoperative OB volume in patients (n=24) with iNPH were significantly smaller compared to healthy controls (average value of OB volume: 48 vs 60ccm, p=0,018 in right OB, p=0,016 in left OB). There was a postoperative increase in volume of the olfactory bulbs. There was no correlation with other radiological parameters. Despite the reduced volume of the OB in iNPH, there was no significant reduction in olfactory function.

Conclusions: Although the ventricle size may be persistent, the olfactory bulb increases in size after successful neurosurgical treatment. Olfactory bulb volume may present an objective parameter for clinical outcome correlation in patients with iNPH. However, larger patient groups are necessary to determine the significance of this finding. The olfactory bulb may present an easily quantifiable structure to measure morphological regeneration.