The Role of Cerebrospinal Fluid Dynamics in Normal Pressure Hydrocephalus Diagnosis and Shunt Prognostication.
CSF dynamics
Extended lumbar drainage
Hydrocephalus shunts
Infusion study
Normal pressure hydrocephalus
Journal
Acta neurochirurgica. Supplement
ISSN: 0065-1419
Titre abrégé: Acta Neurochir Suppl
Pays: Austria
ID NLM: 100962752
Informations de publication
Date de publication:
2021
2021
Historique:
entrez:
11
4
2021
pubmed:
12
4
2021
medline:
8
6
2021
Statut:
ppublish
Résumé
Over the years, there have been several reports and trials of the resistance to cerebrospinal fluid (CSF) outflow (Rout) in normal pressure hydrocephalus (NPH). This work aimed to revisit the utility of testing CSF circulation in a large population of patients clinically presenting with NPH. We retrospectively analyzed the data of 369 NPH patients-either shunted or with endoscopic third ventriculostomy (ETV)-in Cambridge between 1992 and 2018. We determined the patients' outcomes (improvement versus no improvement at 6 months) by applying a threshold on R In our dataset, R Rout can be used for selecting patients for shunt surgery but not for excluding patients from treatment. Critical, multivariable approaches are required to comprehend CSF dynamics and pressure-volume compensation in NPH. Outcome definition and assessment could also be brought to question.
Sections du résumé
BACKGROUND
BACKGROUND
Over the years, there have been several reports and trials of the resistance to cerebrospinal fluid (CSF) outflow (Rout) in normal pressure hydrocephalus (NPH). This work aimed to revisit the utility of testing CSF circulation in a large population of patients clinically presenting with NPH.
MATERIALS AND METHODS
METHODS
We retrospectively analyzed the data of 369 NPH patients-either shunted or with endoscopic third ventriculostomy (ETV)-in Cambridge between 1992 and 2018. We determined the patients' outcomes (improvement versus no improvement at 6 months) by applying a threshold on R
RESULTS
RESULTS
In our dataset, R
CONCLUSION
CONCLUSIONS
Rout can be used for selecting patients for shunt surgery but not for excluding patients from treatment. Critical, multivariable approaches are required to comprehend CSF dynamics and pressure-volume compensation in NPH. Outcome definition and assessment could also be brought to question.
Identifiants
pubmed: 33839875
doi: 10.1007/978-3-030-59436-7_69
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
359-363Références
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