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Role of Cisternography in Diagnosis

A. Everette James, Jr., MD; Frank H. DeLand, MD; Fred J. Hodges III; Henry N. Wagner, Jr., MD

JAMA. 1970;213(10):1615-1622.

Abstract
Normal-pressure hydrocephalus is characterized by neurological symptoms of dementia and awkwardness of movement, cerebrospinal fluid pressure in the normal range, and ventricular enlargement without cortical atrophy. Pneumoencephalograms reveal enlarged ventricles with failure of air to pass over the cerebral convexities. The cisternographic abnormalities are the presence of radioactivity in the enlarged ventricles, abnormality of movement of the injected radioactivity over the cerebral hemispheres, and failure of the radioactivity to concentrate in the sagittal area on delayed scans (24 or 48 hours). Since normal-pressure hydrocephalus is a treatable form of dementia, accurate diagnosis based on clinical manifestations, findings from lumbar puncture, pneumoencephalography, and cisternography is mandatory.

Author Affiliations
From the Division of Nuclear Medicine, the Johns Hopkins Medical Institutions, Baltimore. Dr. James is an advanced academic fellow of the James Picker Foundation recommended by the Committee on; Radiology, National Research Council, National Academy of Science.

Footnotes
Reprint requests to 615 N Wolfe St, Baltimore 21205 (Dr. James).

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