Original scientific paper
https://doi.org/10.3325/cmj.2014.55.388
Volumetric analysis of cerebrospinal fluid and brain parenchyma in a patient with hydranencephaly and macrocephaly – case report
Milan Radoš
; Croatian Institute for Brain Research, School of MedicineUniversity of Zagreb, Zagreb, Croatia
Marijan Klarica
; 2Department of Pharmacology, School of Medicine, University of Zagreb, Zagreb, Croatia
Branka Mučić-Pucić
; Special Hospital for Chronic Children Diseases, Gornja Bistra Bistra, Croatia
Ines Nikić
; Croatian Institute for Brain Research, School of MedicineUniversity of Zagreb, Zagreb, Croatia
Marina Raguž
; Croatian Institute for Brain Research, School of MedicineUniversity of Zagreb, Zagreb, Croatia
Valentina Galkowski
; Croatian Institute for Brain Research, School of MedicineUniversity of Zagreb, Zagreb, Croatia
Dora Mandić
; Croatian Institute for Brain Research, School of MedicineUniversity of Zagreb, Zagreb, Croatia
Darko Orešković
; Department of Molecular Biology, Ruđer Bošković Institute, Zagreb, Croatia
Abstract
The aim of this study was to perform for the first time the
intracranial volumetric analysis of cerebrospinal fluid (CSF)
and brain parenchyma in the supratentorial and infratentorial
space in a 30-year-old female patient with hydranencephaly
and macrocephaly. A head scan performed
using a 3T magnetic resonance was followed by manual
segmentation of the brain parenchyma and CSF on T2
coronal brain sections. The volume of CSF and brain parenchyma
was measured separately for the supratentorial
and infratentorial space. The total volume of the intracranial
space was 3645.5 cm3. In the supratentorial space, the
volume of CSF was 3375.2 cm3 and the volume of brain parenchyma
was 80.3 cm3. In the infratentorial space, the volume
of CSF was 101.3 cm3 and the volume of the brain parenchyma
was 88.7 cm3. In the supratentorial space, there
was severe malacia of almost all brain parenchyma with
no visible remnants of the choroid plexuses. Infratentorial
structures of the brainstem and cerebellum were hypoplastic
but completely developed. Since our patient had
no choroid plexuses in the supratentorial space and no
obstruction between dural sinuses and CSF, development
of hydrocephalus and macrocephaly cannot be explained
by the classic hypothesis of CSF physiology with secretion,
unidirectional circulation, and absorption as its basic postulates.
However, the origin and turnover of the enormous
amount of intracranial CSF volume, at least 10-fold larger
than normal, and the mechanisms of macroencephaly development
could be elucidated by the new hypothesis of
CSF physiology recently published by our research team.
Keywords
Hrčak ID:
129944
URI
Publication date:
15.8.2014.
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