Fig. 6

Female patient presented with gait disturbance and difficult urinary control. a MRI axial FLAIR, mild dilatation of the lateral ventricles, and white matter abnormal hyperintensity representing ischemic changes. b 3D DRIVE image showing patent normal aqueduct. c Sagittal phase image in systole showing CSF flow in the aqueduct of Sylvius as shades of white. d Velocity time curve showing CSF in both diastole and systolic PDV = 1.4 cm/s, PSV = 2.2 cm/s, and Vmax = (1.4 + 2.2)/2 = 1.8 cm/s. e CSF flow curve associated table, Forward flow volume = 10 μl, and backward flow volume = 14 μl, and so the SV = (10 + 14)/2 = 12 μl/cycle. Aqueduct area = 0.05 cm². So the maximum flow was calculated as follows: maximum flow = 1.8 × 0.05 = 0.09 cm³/s. Diagnosis is hypodynamic CSF flow consistent with brain atrophy