SynthesisActa neurochirurgica2024
Volumes and velocities: Meta-analysis of PC-MRI studies in normal pressure hydrocephalus.
Synthesis in Acta neurochirurgica, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
5 citing papers in PubMed.
- Moving on in hydrocephalus imaging: from 2D to 3D biomarkers.Acta neurochirurgica · 2026Review
- Cerebrospinal fluid mechanics across CNS barriers: from production, circulation, and clearance to mechanomedicine.Frontiers in neuroscience · 2026Review
- Variability in the circulation of cerebrospinal fluid: causes and clinical implications for intraventricular drug delivery.Frontiers in drug delivery · 2026Review
- Idiopathic CSF dynamic disturbances causing headache: a narrative review.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Review
- Atrial volume reduction correlates with early improvement in hemorrhage-associated normal pressure hydrocephalus-a 3D computed tomography volumetric study.Frontiers in neurologyArticle
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposePhase contrast magnetic resonance imaging (PC-MRI) represents an opportunity to non-invasively investigate cerebral spinal fluid (CSF) flow in patients with idiopathic normal pressure hydrocephalus (iNPH). Studies in recent years have explored the diagnostic and prognostic value of PC-MRI derived parameters. This review aims to identify all PC-MRI studies of iNPH published since 2010, synthesise a review based on collated results, and analyse specific flow parameters identified in the selected studies.
methodsOur protocol was prospectively registered on PROSPERO [CRD42020180826]. We systematically searched four databases: Pubmed, Web of Science, Ovid, and Cochrane library to identify all eligible studies. Quality assessment was performed using a modified Newcastle-Ottawa Scale [19]. Systematic review was conducted according to Prisma guidelines. A random-effects model was used to perform meta-analysis on the available flow parameters.
resultsEighteen records were identified for inclusion. Five studies were eligible for meta-analysis, representing 107 iNPH patients and 82 controls. CSF flow parameters available for analysis were stroke volume and peak velocity. Both were significantly higher than controls (p = 0.0007 and p = 0.0045 respectively) according to our random-effects analysis, consistent with a model of hyper-dynamic CSF in iNPH. Our systematic review revealed average stroke volumes in iNPH ranging from 43uL to over 200uL. Peak velocity values ranged from 5.9 cm/s to 12.8 cm/s.
conclusionSignificant increases in stroke volume and peak velocity values in iNPH patients suggest a place for PC-MRI as supplementary evidence in the diagnostic work-up of iNPH. Although shunting reduces aqueductal stroke volume and peak velocity, the ability of pre-shunt values to reliably predict treatment response remains complicated. We suggest that it may be more appropriate to consider a range of values that reflect varying probabilities of shunt success. We recommend that future studies should prioritise standardising PC-MRI protocols, and before then PC-MRI findings should be considered supportive rather than determinative.
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