Narrow Sulci at the Medial Brain Surface: A Feature of Normal-Pressure Hydrocephalus in Computerized Tomography ?

Abstract

In computerized tomography (CT), obliterated cerebral sulci represent a common sign of raised intracranial pressure, which is found in obstructive hydrocephalus; the sign more or less fails in malresorptive hydrocephalus and is totally missing in ex vacuo hydrocephalus. Whereas it is hardly possible to distinguish between a malresorptive and an ex vacuo hydrocephalus on the basis of the sulci of the convexity, the sulci of the medial brain surface seem to present themselves as a differentiating feature. Figure 1 shows a malresorptive hydrocephalus with open sulci at the convexity, but not at the medial brain surface. Figure 2 shows an ex vacuo hydrocephalus with wide sulci both at the medial brain surface and at the convexity.