{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T01:49:20Z","timestamp":1791942560609,"version":"4.3.4"},"reference-count":42,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2014,7,28]],"date-time":"2014-07-28T00:00:00Z","timestamp":1406505600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"published-print":{"date-parts":[[2014,8]]},"abstract":"Abstract<\/jats:title>Objective<\/jats:title>We sought to identify the prevalence of MRI<\/jats:styled-content> features of disproportionately enlarged subarachnoid space hydrocephalus in possible idiopathic normal pressure hydrocephalus (DESH\u2010iNPH<\/jats:styled-content>) and to describe the clinico\u2010radiological features and outcomes of a community\u2010based investigation (The Vienna Trans\u2010Danube Aging study).<\/jats:p><\/jats:sec>Methods<\/jats:title>Of the 697 inhabitants (all 75\u00a0years old), 503 completed extensive neurological examinations at baseline and were followed up every 30\u00a0months thereafter with MRI<\/jats:styled-content>s, mini\u2010mental state examination (MMSE<\/jats:styled-content>), and the Unified Parkinson Disease Rating Scale\u2010Motor Section (UPDRSM<\/jats:styled-content>). The DESH<\/jats:styled-content>\u2010iNPH<\/jats:styled-content> participant data were compared with the data from participants with Evans index ratios >0.3 (ex vacuo hydrocephalus), cerebral small\u2010vessel diseases, and normal MRI<\/jats:styled-content>s. The widening of perivascular space was also evaluated by MRI<\/jats:styled-content> in these groups.<\/jats:p><\/jats:sec>Results<\/jats:title>Eight participants with DESH<\/jats:styled-content>\u2010iNPH<\/jats:styled-content> (1.6%) and 76 with ex vacuo hydrocephalus (16.1%) at baseline were identified. The mean MMSE<\/jats:styled-content> in DESH<\/jats:styled-content>\u2010iNPH<\/jats:styled-content>, ex vacuo hydrocephalus, and normal MRI<\/jats:styled-content>s was 26.4, 27.9, and 28.3, respectively, and the mean UPDRSM<\/jats:styled-content> was 9.75, 2.96, and 1.87, respectively. After a 90\u2010month follow\u2010up, the mortality rates for DESH<\/jats:styled-content>\u2010iNPH<\/jats:styled-content>, ex vacuo hydrocephalus, and normal MRI<\/jats:styled-content>s were 25.0%, 21.3%, and 10.9%, respectively. The perivascular\u2010space widening scores were significantly smaller in the DESH<\/jats:styled-content>\u2010iNPH<\/jats:styled-content> cases, particularly at the centrum semiovale, compared to cerebral small\u2010vessel disease and ex vacuo hydrocephalus cases.<\/jats:p><\/jats:sec>Interpretation<\/jats:title>The prevalence of DESH<\/jats:styled-content>\u2010iNPH<\/jats:styled-content> was 1.6% for participants aged 75\u00a0years and revealed significantly lower MMSE<\/jats:styled-content> and higher UPDRSM<\/jats:styled-content> scores compared to the ex vacuo hydrocephalus and controls. Moreover, it is suggested that perivascular\u2010space narrowing is a morphological and pathophysiological marker of DESH<\/jats:styled-content>\u2010iNPH<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acn3.87","type":"journal-article","created":{"date-parts":[[2014,7,29]],"date-time":"2014-07-29T02:13:10Z","timestamp":1406599990000},"page":"562-569","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Disproportionate subarachnoid space hydrocephalus\u2014outcome and perivascular space"],"prefix":"10.1002","volume":"1","author":[{"given":"Ichiro","family":"Akiguchi","sequence":"first","affiliation":[{"name":"Center of Neurological and Cerebrovascular Diseases Takeda Hospital Kyoto Japan"},{"name":"Department of Health Science Kyoto Koka Women's University Kyoto 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