Evaluation of the lumbar and ventricular infusion test in the diagnostic strategy of pediatric hydrocephalus and the therapeutic implications

Munch, Tina Nørgaard; Bech-Azeddine, Rachid; Boegeskov, Lars; Gjerris, F.; Juhler, Marianne

doi:10.1007/s00381-006-0186-4

Cited by 6 publications

(3 citation statements)

References 14 publications

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“…Resistance to CSF outflow ( R out ) is calculated and believed to express the CSF absorption capacity. However, investigations in children with hydrocephalus have not been able to find a correlation neither between R out and the continuously monitored ICP [50] nor between R out and the need for shunting [119]. …”

Section: Resultsmentioning

confidence: 99%

Benign external hydrocephalus: a review, with emphasis on management

et al. 2011

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Benign external hydrocephalus in infants, characterized by macrocephaly and typical neuroimaging findings, is considered as a self-limiting condition and is therefore rarely treated. This review concerns all aspects of this condition: etiology, neuroimaging, symptoms and clinical findings, treatment, and outcome, with emphasis on management. The review is based on a systematic search in the Pubmed and Web of Science databases. The search covered various forms of hydrocephalus, extracerebral fluid, and macrocephaly. Studies reporting small children with idiopathic external hydrocephalus were included, mostly focusing on the studies reporting a long-term outcome. A total of 147 studies are included, the majority however with a limited methodological quality. Several theories regarding pathophysiology and various symptoms, signs, and clinical findings underscore the heterogeneity of the condition. Neuroimaging is important in the differentiation between external hydrocephalus and similar conditions. A transient delay of psychomotor development is commonly seen during childhood. A long-term outcome is scarcely reported, and the results are varying. Although most children with external hydrocephalus seem to do well both initially and in the long term, a substantial number of patients show temporary or permanent psychomotor delay. To verify that this truly is a benign condition, we suggest that future research on external hydrocephalus should focus on the long-term effects of surgical treatment as opposed to conservative management.

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Section: Resultsmentioning

confidence: 99%

Benign external hydrocephalus: a review, with emphasis on management

et al. 2011

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“…14 The current clinical indication for the test is to determine the need for shunt placement in selected patients with hydrocephalus, large ventricles, and questionable shunt dependency. The most common output of infusion testing is the R out , 4,14,27,30 which is computed from the static pressures ([P p -P o ]/infusion rate). It should be noted that it is presently unknown where the infused fluid is being absorbed.…”

Section: Ventricular Infusion Testingmentioning

confidence: 99%

“…This observation is consistent with the results of others. 30 Even though pulsatile ICP correlates positively with ICE and there is a proportional relationship between levels of pulsatile ICP and ICE, it is important to note that pulsatile ICP is not synonymous with ICE. This is because the pulsatile ICP and ICE are influenced by several factors, such as fluctuations in cerebral blood volume, blood vessel properties (vascular compliance), partial pressure of carbon dioxide levels, and properties of brain parenchyma (water content and cellular changes).…”

Section: Association Between Pulsatile Icp and Icementioning

confidence: 99%

The correlation between pulsatile intracranial pressure and indices of intracranial pressure-volume reserve capacity: results from ventricular infusion testing

Eide

2016

JNS

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OBJECTIVE The objective of this study was to examine how pulsatile and static intracranial pressure (ICP) scores correlate with indices of intracranial pressure-volume reserve capacity, i.e., intracranial elastance (ICE) and intracranial compliance (ICC), as determined during ventricular infusion testing. METHODS All patients undergoing ventricular infusion testing and overnight ICP monitoring during the 6-year period from 2007 to 2012 were included in the study. Clinical data were retrieved from a quality registry, and the ventricular infusion pressure data and ICP scores were retrieved from a pressure database. The ICE and ICC (= 1/ICE) were computed during the infusion phase of the infusion test. RESULTS During the period from 2007 to 2012, 82 patients with possible treatment-dependent hydrocephalus underwent ventricular infusion testing within the department of neurosurgery. The infusion tests revealed a highly significant positive correlation between ICE and the pulsatile ICP scores mean wave amplitude (MWA) and rise-time coefficient (RTC), and the static ICP score mean ICP. The ICE was negatively associated with linear measures of ventricular size. The overnight ICP recordings revealed significantly increased MWA (> 4 mm Hg) and RTC (> 20 mm Hg/sec) values in patients with impaired ICC (< 0.5 ml/mm Hg). CONCLUSIONS In this study cohort, there was a significant positive correlation between pulsatile ICP and ICE measured during ventricular infusion testing. In patients with impaired ICC during infusion testing (ICC < 0.5 ml/mm Hg), overnight ICP recordings showed increased pulsatile ICP (MWA > 4 mm Hg, RTC > 20 mm Hg/sec), but not increased mean ICP (< 10-15 mm Hg). The present data support the assumption that pulsatile ICP (MWA and RTC) may serve as substitute markers of pressure-volume reserve capacity, i.e., ICE and ICC.

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Minimally Invasive Neurosurgery for Cerebrospinal Fluid Disorders

Guillaume

2010

Neurosurgery Clinics of North America

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Evaluation of the lumbar and ventricular infusion test in the diagnostic strategy of pediatric hydrocephalus and the therapeutic implications

Abstract: R(out) has doubtful value as an indicator for conducting an operation or not and in the choice between EVT and shunt in children. This should be interpreted in the light of a growing understanding of hydrocephalus on a molecular level.

Cited by 6 publications

References 14 publications

Benign external hydrocephalus: a review, with emphasis on management

Benign external hydrocephalus: a review, with emphasis on management

The correlation between pulsatile intracranial pressure and indices of intracranial pressure-volume reserve capacity: results from ventricular infusion testing

Minimally Invasive Neurosurgery for Cerebrospinal Fluid Disorders

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