Diagnosis and Differential Diagnosis of Hydrocephalus in Adults Diagnostik und Differentialdiagnostik des Hydrocephalus beim Erwachsenen

Purpose Hydrocephalus is caused by an imbalance of production and absorption of cerebrospinal fluid (CSF) or obstruction of its pathways, resulting in ventricular dilatation and increased intracranial pressure. Imaging plays a crucial role in the diagnosis, differential diagnosis and planning of treatment. Methods This review article presents the different types of hydrocephalus und their typical imaging appearance, describes imaging techniques, and discusses differential diagnoses of the different forms of hydrocephalus. Results and Conclusion Imaging plays a central role in the diagnosis of hydrocephalus. While magnetic resonance (MR) imaging is the first-line imaging modality, computed tomography (CT) is often the first-line imaging test in emergency patients. Key points ▪ Occlusive hydrocephalus is caused by obstruction of CSF pathways. ▪ Malabsorptive hydrocephalus is caused by impaired CSF absorption. ▪ The MR imaging protocol should always include sagittal high-resolution T2-weighted images. ▪ When an inflammatory etiology is suspected, imaging with contrast agent administration is necessary. Citation Format ▪ Langner S, Fleck S, Baldauf J et al. Diagnosis and Differential Diagnosis of Hydrocephalus in Adults. Fortschr Röntgenstr 2017; 189: 728–739