FIGURE.

Characteristic imaging and classification for patients with adult hydrocephalus. A, Absence of DESH. B, DESH present: Sylvian fissure enlargement and tight high-convexity effacement are present. Both patients were treated with ventricular shunting and had improvement in symptoms. A scaled measurement of the Sylvian fissure is provided to illustrate the extent of fissure enlargement in this representative case. However, consistent with the defining features of DESH in the literature,^3–5 quantitative measurement was not used as scoring criterion during blinded neuroradiologist review.