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The results suggest that leptomeningeal fibrosis is not the only pathoanatomic basis of increased r(out) andor b-wave activity in patients with nph and that various degenerative changes in the parenchyma may be responsible for the altered cerebrospinal fluid dynamics characteristic of nph. Normal-pressure hydrocephalus (nph) is a potentially treatable syndrome with abnormal cerebrospinal fluid dynamics. The animals were killed at varying intervals of time, and histological examinations were performed.

An analysis of our records revealed 12 consecutive patients diagnosed as having rsd before undergoing scs. Both dosimetric methods showed a steep dose-distance fall-off relationship (proportional to the reciprocal of the cube of the distance from the probe tip). The radiobiology was characterized by in vivo irradiation of rat liver, dog liver, and dog brain.

Eight of the 12 patients had undergone previous ablative sympathectomy. Rats and dogs that were killed weeks to months after liver irradiation tended to have sharply demarcated lesions. Eight patients reported excellent pain relief, and four patients described good results.

Heat transfer from the probe to dog brain was studied in vivo by placing thermocouple sensors around the probe tip before irradiating. The tissue temperature elevation 1 cm from the tip never exceeded 0. Meningeal fibrosis andor obliteration of the subarachnoid space has been suggested as the pathoanatomic basis.

The study involved a group of 38 consecutively studied patients with clinical and radiological evidence of idiopathic nph, for whom a frontal brain biopsy was obtained. The level of pain present pre- and postoperatively was determined by administering a modified mcgill pain questionnaire and a visual analog scale to each patient. Furthermore, possible correlations between white matter lesion scores, ventricular width, and age were investigated.

Scs is an effective treatment for the pain of rsd, including recurrent pain after ablative sympathectomy. The device is lightweight, handheld, and battery-powered, and it emits x-ray radiation from the tip of a probe 3 mm in diameter by 10 cm in length. We have used epidural scs for pain control during the past 15 years. The low morbidity of this procedure and its efficacy in patients with refractory pain related to rsd suggest that scs is superior to ablative sympathectomy in the management of rsd. For 29 patients, hydrodynamic criteria of nph were fulfilled and a ventriculoperitoneal shunt was performed.


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    For 29 patients, hydrodynamic criteria of nph were fulfilled and a ventriculoperitoneal shunt was performed. The study involved a group of 38 consecutively studied patients with clinical and radiological evidence of idiopathic nph, for whom a frontal brain biopsy was obtained. Both dosimetric methods showed a steep dose-distance fall-off relationship (proportional to the reciprocal of the cube of the distance from the probe tip). Histological examination of the brains of dogs that were killed acutely after irradiation did not show evidence of inflammation, edema, or hemorrhage. The tissue temperature elevation 1 cm from the tip never exceeded 0.

    The dosimetry was characterized by two independent methods thermoluminescent dosimeters and radiochromic film. An analysis of our records revealed 12 consecutive patients diagnosed as having rsd before undergoing scs. Eight patients reported excellent pain relief, and four patients described good results. The level of pain present pre- and postoperatively was determined by administering a modified mcgill pain questionnaire and a visual analog scale to each patient. The radiobiology was characterized by in vivo irradiation of rat liver, dog liver, and dog brain.

    The low morbidity of this procedure and its efficacy in patients with refractory pain related to rsd suggest that scs is superior to ablative sympathectomy in the management of rsd. Rats and dogs that were killed weeks to months after liver irradiation tended to have sharply demarcated lesions. We have used epidural scs for pain control during the past 15 years. Meningeal fibrosis andor obliteration of the subarachnoid space has been suggested as the pathoanatomic basis. Heat transfer from the probe to dog brain was studied in vivo by placing thermocouple sensors around the probe tip before irradiating. The animals were killed at varying intervals of time, and histological examinations were performed. We report the design and initial characterization of the dosimetry and radiobiology of a novel device for interstitial stereotactic radiosurgery. All 12 patients experienced relief of pain after trial stimulation and had their systems permanently implanted. Scs is an effective treatment for the pain of rsd, including recurrent pain after ablative sympathectomy. The device is lightweight, handheld, and battery-powered, and it emits x-ray radiation from the tip of a probe 3 mm in diameter by 10 cm in length.

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