THE INTERPRETATION OF MR-IMAGES OF THE IDIOPATHIC NORMAL PRESSURE HYDROCEPHALUS, ALZHEIMER'S DISEASE AND THEIR COMBINATION

The most common neurodegenerative diseases in the elderly and senile, the main manifestation of which are intellectualmnestic disorders, include Alzheimer's disease, mixed and vascular dementia, and idiopathic normal pressure hydrocephalus. Idiopathic normal pressure hydrocephalus, or the Hakim-Adams syndrome, is characterized by the expansion of liquor-containing spaces, which leads to a specific clinical picture: gait disturbance, cognitive deficit and dysuric disorders. The diagnosis is complicated by its combination with Alzheimer's disease in 75% of cases (the syndrome «AD-iNPH»). Magnetic resonance imaging is a method that helps in conducting differential diagnosis and determining further treatment tactics. The study revealed specific neuroimaging signs using several scales: iNPHRadScale, MTA scale of atrophy of the medial temporal lobe, GCA scale of global (diffuse) cortical atrophy, scale of atrophy of the parietal lobe (Koedam). There were examined 45 people which old was 50 to 90 years: 20 with a diagnosis of idiopathic normal pressure hydrocephalus, 17 with Alzheimer's disease, 8 with the «AD-iNPH» syndrome. It was found that Hakim-Adams syndrome is characterized by an expansion of cerebrospinal fluid cavities, which was confirmed by the iNPHRadScale scale: acute angle of the corpus callosum, presence of a high Evans index, expansion of sylvian fissures, periventricular hyperintensity, narrowing of paraphalcinar grooves without significant atrophy. Patients with «AD-iNPH» syndrome were characterized by the expansion of cerebrospinal cavities of the brain, obtuse angle of the corpus callosum, the presence of periventricular hyperintensity, a decrease in the height of the hippocampus and expansion of the choroid gap, diffuse atrophy of the brain substance, that is, a combination of dilatation and neurodegenerative processes. The atrophy of the substance of the brain was characteristic of patients with Alzheimer's disease, which is confirmed by the scales of atrophy of the medio-basal parts of the temporal and parietal lobes. It is necessary to comprehensively evaluate brain MR-images in patients with suspected idiopathic normal pressure hydrocephalus and Alzheimer's disease using several scales.

iNPHRadScale, idiopathic normal pressure hydrocephalus, Alzheimer's disease, «AD-iNPH» syndrome, neuroimaging, iNPHRadScale, MTA-scale, GCA-scale, parietal lobe atrophy scale