Imaging

Hydrocephalus

Preliminary Diagnosis: Hydrocephalus

I. What imaging technique is first-line for this diagnosis

  • Noncontrast CT of the brain

II. Describe the advantages and disadvantages of this technique for diagnosis of hydrocephalus.

Advantages

  • Less expensive and faster to perform than MR imaging

Disadvantages

  • Exposes patients to ionizing radiation

III. What are the contraindications for the first-line imaging technique?

  • May be contraindicated in pregnant patients

IV. What alternative imaging techniques are available?

  • MR of the brain with and without contrast

V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of hydrocephalus.

MR of the brain with and without contrast

Advantages

  • Able to detect soft tissue mass, fluid collecting, or subtle parenchymal or vascular abnormality that may serve as an etiology for hydrocephalus

  • Does not expose the patient to ionizing radiation

Disadvantages

  • Expensive

  • Time-consuming

  • Requires significant patient cooperation to minimize motion artifact

VI. What are the contraindications for the alternative imaging techniques?

MR of the brain with and without contrast

  • Contraindicated in patients with non-MR compatible hardware

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