Disproportionately enlarged subarachnoid space hydrocephalus (DESH)

Evidence-based neurology checklist on disproportionately enlarged subarachnoid space hydrocephalus (desh): Pathology DESH is an imaging marker of idiopathic normal pressure hydrocephalus (NPH) It is complete in 64% of cases and incomplete in 23% It may be misinterpreted as cortical atrophy…

Pathology

  • DESH is an imaging marker of idiopathic normal pressure hydrocephalus (NPH)
  • It is complete in 64% of cases and incomplete in 23%
  • It may be misinterpreted as cortical atrophy

Radiological features

Correlations

References

  1. Ishikawa M, Oowaki H, Takezawa M, et al. Disproportionately enlarged subarachnoid space hydrocephalus in idiopathic normal-pressure hydrocephalus and its implication in pathogenesis. Acta Neurochir Suppl 2016; 122:287-290. 
  2. McCarty AM, Jones DT, Dickson DW, Graff-Radford NR. Disproportionately enlarged subarachnoid-space hydrocephalus (DESH) in normal pressure hydrocephalus misinterpreted as atrophy: autopsy and radiological evidence. Neurocase 2019; 25:151-155. 
  3. Shinoda N, Hirai O, Hori S, et al. Utility of MRI-based disproportionately enlarged subarachnoid space hydrocephalus scoring for predicting prognosis after surgery for idiopathic normal pressure hydrocephalus: clinical research. J Neurosurg 2017; 127:1436-1442.
  4. Akiba C, Gyanwali B, Villaraza S, et al. The prevalence and clinical associations of disproportionately enlarged subarachnoid space hydrocephalus (DESH), an imaging feature of idiopathic normal pressure hydrocephalus in community and memory clinic based Singaporean cohorts. J Neurol Sci 2020; 408:116510.
  5. Ahmed AK, Luciano M, Moghekar A, et al. Does the presence or absence of DESH predict outcomes in adult hydrocephalus? AJNR 2018; 39:2022-2026. 
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