Lancet: Have you ever seen compensatory hydrocephalus like this?

Summary of history: Female, 62 years of age, with a history of high blood pressure and well-controlled type 2 diabetes

Upon admission, Glasgow Coma Score (GCS) 3, body temperature 39.

Brain MRI was unfortified, T1 and T2 showed enlarged supraternal and subslatrial ventricles, and no midbrain aqueduct abnormalities

Treatment: Extraventricular drainage can be used to relieve possible acute hydrocephalus, but her intracranial pressure is only 5 mmHg (normal 5–15 mmHg) and remains at 5–10 mmHg, so the catheter

Commutation hydrocephalus

Definition: Compensated hydrocephalus, also known as "hydrocephalus ex vacuo", is a spatial compensatory enlargement of the cerebrospinal fluid, and characteristic imaging changes are ventricles or subarachnoid enlargements

It is often classified as traffic hydrocephalus, does not hinder the flow of cerebrospinal fluid, and does not belong to the common category of

Pathology:

Often in the elderly, 1.

differential diagnosis

Accurate identification of hydrocephalus and compensatory increased CSF space (cerebral atrophy) is difficult to identify imagingly in some cases

Image characteristics

Features that support hydrocephalus include:

Temporal angle dilation

The fissures around the hippocampus have not widened

The radius of the frontal angle increases

Sharp ventricular angle

Ephemeral fluidity causes periventricular space edema

MR shows intraventricular air-overhang caused by cerebrospinal fluid flow

Third ventricular enlargement: the median sagittal surface

Upper corpus callosum displacement: midpoint sagittal surface

Posterior vault depression: midpoint sagittal surface

Papillonal distance decreases: the median sagittal surface

The angle of the corpus callosum is reduced

Buckle band groove signs

This case amply demonstrates the brain's strong regulatory ability to maintain a normal state of consciousness and function, despite such severe chronic hydrocephalus