| ▲ A new diagnostic technique and treatment effect on the cerebrospinal fluid outflow tract that causes dementia was announced. (Photo = DB) |
[메디컬투데이=김영재 기자] A new diagnostic technique and treatment effect for the cerebrospinal fluid outflow tract that causes dementia was announced.
The results of a study showing that surgical treatment for cerebrospinal fluid leakage is effective in preventing dementia was published in the journal ‘Alzheimer’s & Dementia’.
When nerve cells in the frontal and temporal lobes of the brain are damaged, a type of early-onset dementia called frontotemporal dementia (FTD) can occur. FTD is relatively rare in the elderly compared to other types of dementia, but is the most common cause of dementia in people under the age of 60.
Some patients with FTD fall under ‘behavioral frontotemporal dementia (bvFTD)’, which involves gradual changes in behavior, personality, thinking, etc. do. On the other hand, memory problems characteristic of dementia in bvFTD occur at the end of the disease.
Cerebrospinal fluid provides buoyancy to the brain and acts as a shock absorber. When the cerebrospinal fluid leaks, the brain sags inside the skull, interfering with its normal functioning. Signs of cerebrospinal fluid leak include severe headache that improves when lying down and daytime sleepiness that does not improve even with sound sleep.
Magnetic resonance imaging (MRI) can reveal brain sagging relatively accurately, but it can often be mistaken for other disorders and does not always identify the cause of cerebrospinal fluid leakage. CT myelogram can pinpoint damage or cysts in the membrane surrounding the cerebrospinal fluid, but limitations exist because the cerebrospinal fluid may leak into a vein through an almost invisible fistula.
A more specialized CT scan called ‘digital subtractive myelogram (DSM)’ is needed to detect these leaks. The test identifies the outflow route of the cerebrospinal fluid through a technique of injecting a fluorescent substance into the cerebrospinal fluid and tracking the movement of the substance.
In this study, the researchers performed the DSM test on 21 patients with bvFTD who exhibited brain sagging.
They found cerebrospinal fluid-venous fistulas in a total of nine patients, and successfully reversed brain sagging and alleviated dementia symptoms in all nine patients through fistula closure surgery. They gave treatment to alleviate brain sagging to the remaining 12 patients, but only 3 of them showed symptom relief.
“More efforts are needed to improve the detection rate of cerebrospinal fluid leaks in these patients,” the researchers said.
Reporter Kim Young-jae of Medical Today (wannabefd21@mdtoday.co.kr)
[저작권자ⓒ 메디컬투데이. 무단전재-재배포 금지]
