Hydrocephalus vs. atrophy

Accurately determining the cause of ventriculomegaly between hydrocephalus and atrophy (compensatory enlargement of the CSF spaces) can be, at times, challenging in image interpretation.

Radiographic features

Features that favour hydrocephalus include:

  • dilatation of the temporal horns
  • lack of dilatation of parahippocampal fissures 4
  • increased frontal horn radius
  • acute ventricular angles
  • peri-ventricular interstitial oedema from transependymal flow 
  • intraventricular flow void from CSF movement on MR 
  • widening of the third ventricular recesses: midsagittal plane 
  • upward displacement of corpus callosum 3: midsagittal plane
  • depression of the posterior fornix: midsagittal plane
  • decreased mamillopontine distance: midsagittal plane
  • narrow callosal angle
  • cingulate sulcus sign
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Article Information

rID: 9881
Section: Gamuts
Tag: cases
Synonyms or Alternate Spellings:

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    Case 1: communicating hydrocephalus
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    Colloid cyst : T1
    Case 2: obstructing hydrocephalus
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