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Normal-pressure hydrocephalus (NPH) is presumed to result from decreased CSF absorption, leading to hyperdynamic CSF flow into brain parenchyma, particularly within periventricular white matter (PWM). Chronic infarctions resulting from Binswanger disease (BD) can clinically and radiographically resemble the PWM changes seen in NPH. Therefore, the ability to discern which patients truly have NPH and to predict which patients with NPH might respond to CSF shunting would be of great value.
In this study, researchers tested whether diffusion-weighted imaging (DWI) could help distinguish BD from NPH and whether changes on DWI correlate with clinical improvement after CSF shunting in NPH. DWI measures the freedom of movement of water molecules thr…