[Gamma cysternographic data in hydrocephalus and post-traumatic lesions].

With pneumoencephalography and pressure perfusions tests, the gamma-cisternography is a method of choice for establishing a reliable diagnosis of Normal Pressure Hydrocephalus (NPH) which concept was introduced by HAKIM. The gammacisternography allows to establish the diagnosis of NPH when a persistent ventricular filling is present and to find, very often, the etiological factor by showing the absence of radioactivity over the subarachnoïd pathways along the convexities at any stage or delayed and abnormal CSF absorption. The gammacisternography permits also to explore with 111 In DTPA the high risk patients who develop gradually over the course of months and years a NPH after a head trauma, a meningitis, a subarachnoïd hemorrhage or a neuro-surgery treatment. The NPH is present only 12 to 15% of our dementia cases with gait disturbance. Nevertheless, the search for such cases remains worthwhile as the patient may be able to return to a useful life after shunting procedure. The indication for shunting is not possible ot assess on scintigraphic results alone. It must be kept in mind that the abnormalities of CSF flow may be transient, may progress or regress. The shunting may be decided if the scintigraphic pattern remains unchanged and if the clinical symptoms are going worse. The pronostic is better in statistics after ventricular shunting when the NPH scintigraphic pattern is present. The valvo-scintigraphy can also evaluate the function of a shunt during the post-operative period.