Volumetric analysis of cerebrospinal fluid and brain parenchyma in a patient with hydranencephaly and macrocephaly – case reportReport as inadecuate




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Croatian medical journal, Vol.55 No.4 August 2014. -

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.



Author: Milan Radoš - ; Croatian Institute for Brain Research, School of MedicineUniversity of Zagreb, Zagreb, Croatia Marijan Klarica -

Source: http://hrcak.srce.hr/



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