Changes in intracranial pulse pressure amplitudes after shunt implantation and adjustment of shunt valve opening pressure in normal pressure hydrocephalus |
| |
Authors: | Per Kristian Eide Wilhelm Sorteberg |
| |
Institution: | (1) Department of Neurosurgery, Division of Clinical Neuroscience, The National Hospital Rikshospitalet, 0027 Oslo, Norway |
| |
Abstract: | Summary
Background We have previously reported that the intracranial pulse pressure amplitudes were elevated in idiopathic normal pressure hydrocephalus
(NPH) patients responding to shunt surgery. Whether or not shunt implantation or adjustment of the shunt valve opening pressure
modifies the intracranial pulse pressure amplitudes in NPH patients remains to be established. This report summarises our
observations.
Patients and methods Thirteen patients with NPH (idiopathic in nine and secondary in four) are presented in whom continuous intracranial pressure
(ICP) monitoring was done before and after shunt implantation. In two, ICP monitoring was also done during adjustment of shunt
valve opening pressure. The mean ICP and mean ICP wave amplitude (i.e. pulse pressure amplitudes) were determined in 6-s time
windows.
Results After shunt implantation there was a fall in both mean ICP and mean ICP wave amplitude; the reduction in the two ICP parameters
correlated significantly. However, mean ICP in the supine position was normal (i.e. <15 mmHg) in 12 of 13 patients before
shunt placement, and remained normal after shunting. According to our criteria, the mean ICP wave amplitudes were elevated
before shunting in 12 of 13 patients and became “normalised” the day after shunting in nine patients. The reduction in mean
ICP wave amplitude after shunt was highly significant at the group level. Moreover, adjustment of shunt valve opening pressure
modified the levels of mean ICP wave amplitudes.
Conclusions The present observations in 13 NPH patients indicate that shunt implantation reduces mean ICP wave amplitudes. Moreover, the
level of reduction can be tailored by adjustment of the shunt valve opening pressure. |
| |
Keywords: | Intracranial pressure Pulse pressure amplitudes Normal pressure hydrocephalus Shunt valve opening pressure Clinical outcome |
本文献已被 PubMed SpringerLink 等数据库收录! |
|