UNASSIGNED: OBJECTIVE The presence of disproportionately enlarged subarachnoid space @entity1276 (DESH) on brain imaging is a recognized finding of idiopathic normal pressure @entity1276 (iNPH), but the features of DESH can vary across @entity1 . The aim of this study was to evaluate the utility of MRI-based DESH scoring for predicting prognosis after surgery. METHODS In this single-center, retrospective cohort study, the DESH score was determined by consensus between a group of neurosurgeons, neurologists, and a neuroradiologist based on the preoperative MRI findings of the @entity1 with suspected iNPH. The DESH score was composed of the following 5 items, each scored from 0 to 2 (maximum score 10 points): ventriculomegaly, dilated sylvian fissures, tight high convexity, acute callosal angle, and focal @entity384 . The association between the DESH score and improvement of the scores on the @entity2653 ( @entity2653 ), iNPH Grading Scale (iNPHGS), Mini-Mental State Examination (MMSE), Trail Making Test-A (TMT-A), and Timed 3-Meter Up and Go Test (TUG-t) was examined. The primary end point was improvement in the @entity2653 score at 1 year after surgery, and the secondary outcome measures were the iNPHGS, MMSE, TMT-A, and TUG-t scores at 1 year after surgery. Improvement was determined as improvement of 1 or more levels on @entity2653 , >=  1 point on iNPHGS, >=  3 points on MMSE, a decrease of > 30% on TMT-A, and a decrease of > 10% on TUG-t. RESULTS The mean DESH score for the 50 @entity1 (mean age 77.6    5.9 years) reviewed in this study was 5.58    2.01. The mean rate of change in the @entity2653 score was -0.50    0.93, indicating an inverse correlation between the DESH score and rate of change in the @entity2653 score (r = -0.749). @entity1 who showed no improvement in @entity2653 score tended to have a low DESH score as well as low preoperative MMSE and TMT-A scores. There were no differences in the areas of deep white matter hyperintensity and periventricular hyperintensity on the images between @entity1 with and without an improved @entity2653 score (15.6% vs 16.7%, respectively; p = 1.000). The DESH score did differ significantly between @entity1 with and without improved scores on the iNPHGS (6.39    1.76 vs 4.26    1.69, respectively; p < 0.001), MMSE (6.63    1.82 vs 5.09    1.93; p = 0.010), TMT-A (6.32    1.97 seconds vs 5.13    1.93 seconds; p = 0.042), and TUG-t (6.48    1.81 seconds vs 4.33    1.59 seconds; p < 0.001). CONCLUSIONS MRI-based DESH scoring is useful for the prediction of neurological improvement and prognosis after surgery for iNPH.

Utility of MRI-based disproportionately enlarged subarachnoid space @entity1276 scoring for predicting prognosis after surgery for idiopathic normal pressure XXXX : clinical research.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity384 :: ('MESH:D002311', 'Disease') :: ['sulcal dilation'] @entity2653 :: ('MESH:C538175', 'Disease') :: ['mRS', 'modified Rankin Scale'] @entity1276 :: ('MESH:D006849', 'Disease') :: ['hydrocephalus']
@entity1276 :: (MESH:D006849,Disease) :: ['hydrocephalus']
