المؤلفون: da Silva Mendes, Gabriel André, Hayashi, Cintya Yukie, Vilela, Gustavo Henrique Frigieri, Kido, Lissa, Teixeira, Manoel Jacobsen, Pinto, Fernando Campos Gomes

المصدر: Neuropsychiatric Disease & Treatment; May2023, Vol. 19, p1127-1143, 17p

مصطلحات موضوعية: CEREBROSPINAL fluid shunts, PHYSICAL therapy assessment, PATIENT compliance, HYDROCEPHALUS, MAGNETIC resonance imaging, NEUROPSYCHOLOGICAL tests

مستخلص: Background: Normal pressure hydrocephalus is a disease directly related to the change in intracranial compliance and consequent repercussions in the brain parenchyma. Invasive monitoring of such parameters proves to be reliable especially for prognosis in neurocritical patients; however, it is not applicable in an outpatient service setting. The present study describes the comparison between the tap test results and the parameters obtained with a non-invasive sensor for monitoring intracranial compliance in patients with suspected NPH. Methods: Twenty-eight patients were evaluated before and after lumbar puncture of 50mL of CSF (the tap test), comprising clinical assessment, magnetic resonance imaging, physical therapy assessment using the Timed Up and Go test, Dynamic Gait Index, BERG test, neuropsychological assessment, and recording of non-invasive intracranial compliance data using the Brain4care^® device in three different positions (lying, sitting, and standing) for 5 min each. The tap test results were compared to the Time to Peak and P2/P1 ratio parameters obtained by the device. Results: The group that had a positive Tap test result presented a median P2/P1 ratio greater than 1.0, suggesting a change in intracranial compliance. In addition, there was also a significant difference between patients with positive, negative, and inconclusive results, especially in the lying position. Conclusion: A non-invasive intracranial compliance device when used with the patient lying down and standing up obtained parameters that suggest correspondence with the result of the tap test. [ABSTRACT FROM AUTHOR]

: Copyright of Neuropsychiatric Disease & Treatment is the property of Dove Medical Press Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Mendes GAS, Hayashi CY, Vilela GHF, Kido L, Teixeira MJ, Pinto FCG

المصدر: Neuropsychiatric Disease and Treatment, Vol Volume 19, Pp 1127-1143 (2023)

مصطلحات موضوعية: normal pressure hydrocephalus, intracranial pressure, biomedical technology, cerebrospinal fluid pressure, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571, Neurology. Diseases of the nervous system, RC346-429

الوصف: Gabriel André da Silva Mendes,1,2 Cintya Yukie Hayashi,2,3 Gustavo Henrique Frigieri Vilela,3 Lissa Kido,3 Manoel Jacobsen Teixeira,2 Fernando Campos Gomes Pinto2 1Physiotherapy Nucleous, Hospital of the State Public Servant of São Paulo, São Paulo City, São Paulo State, Brazil; 2Brain Hydrodynamics Group, Department of Neurosurgery, Hospital das Clínicas, University of São Paulo, São Paulo City, São Paulo State, Brazil; 3Braincare Desenvolvimento e Inovação Tecnológica S.A, São Carlos City, São Paulo State, BrazilCorrespondence: Gabriel André da Silva Mendes, Email mendes1986@yahoo.com.brBackground: Normal pressure hydrocephalus is a disease directly related to the change in intracranial compliance and consequent repercussions in the brain parenchyma. Invasive monitoring of such parameters proves to be reliable especially for prognosis in neurocritical patients; however, it is not applicable in an outpatient service setting. The present study describes the comparison between the tap test results and the parameters obtained with a non-invasive sensor for monitoring intracranial compliance in patients with suspected NPH.Methods: Twenty-eight patients were evaluated before and after lumbar puncture of 50mL of CSF (the tap test), comprising clinical assessment, magnetic resonance imaging, physical therapy assessment using the Timed Up and Go test, Dynamic Gait Index, BERG test, neuropsychological assessment, and recording of non-invasive intracranial compliance data using the Brain4care® device in three different positions (lying, sitting, and standing) for 5 min each. The tap test results were compared to the Time to Peak and P2/P1 ratio parameters obtained by the device.Results: The group that had a positive Tap test result presented a median P2/P1 ratio greater than 1.0, suggesting a change in intracranial compliance. In addition, there was also a significant difference between patients with positive, negative, and inconclusive results, especially in the lying position.Conclusion: A non-invasive intracranial ...

العلاقة: https://www.dovepress.com/comparison-of-noninvasive-measurements-of-intracranial-with-tap-test-r-peer-reviewed-fulltext-article-NDTTest; https://doaj.org/toc/1178-2021Test; https://doaj.org/article/5e11c6fc1e4c46b2baa4376b5ba99b57Test

الإتاحة: https://doaj.org/article/5e11c6fc1e4c46b2baa4376b5ba99b57Test

المؤلفون: Kasprowicz, M.¹, Lalou, D. A.², Czosnyka, M.^3,4, Garnett, M.⁵, Czosnyka, Z.³

المصدر: Acta Neurologica Scandinavica. Sep2016, Vol. 134 Issue 3, p168-180. 13p.

مصطلحات موضوعية: *HYDROCEPHALUS, *INTRACRANIAL pressure, *CEREBROSPINAL fluid pressure, *CEREBROSPINAL fluid shunts, *DIAGNOSIS, *THERAPEUTICS

مستخلص: Clinical measurement of intracranial pressure ( ICP) is often performed to aid diagnosis of hydrocephalus. This review discusses analysis of ICP and its components' for the investigation of cerebrospinal fluid ( CSF) dynamics. The role of pulse, slow and respiratory waveforms of ICP in diagnosis, prognostication and management of hydrocephalus is presented. Two methods related to ICP measurement are listed: an overnight monitoring of ICP and a constant-rate infusion study. Due to the dynamic nature of ICP, a 'snapshot' manometric measurement of ICP is of limited use as it might lead to unreliable results. Therefore, monitoring of ICP over longer time combined with analysis of its waveforms provides more detailed information on the state of pressure-volume compensation. The infusion study implements ICP signal processing and CSF circulation model analysis in order to assess the cerebrospinal dynamics variables, such as CSF outflow resistance, compliance of CSF space, pressure amplitude, reference pressure, and CSF formation. These parameters act as an aid tool in diagnosis and prognostication of hydrocephalus and can be helpful in the assessment of a shunt malfunction. [ABSTRACT FROM AUTHOR]

المؤلفون: Czosnyka, Z. H.¹, Cieslicki, K.², Czosnyka, M.¹ zc200@medschl.cam.ac.uk, Pickard, J. D.¹

المصدر: Medical & Biological Engineering & Computing. Jan2005, Vol. 43 Issue 1, p71-77. 7p. 2 Diagrams, 1 Chart, 5 Graphs.

مصطلحات موضوعية: HYDROCEPHALUS, BRAIN diseases, KLEEBLATTSCHADEL syndrome, INTRACRANIAL pressure, CEREBROSPINAL fluid pressure, CEREBROSPINAL fluid

مستخلص: The majority of contemporary hydrocephalus valves are designed to introduce a low resistance to flow into the cerebrospinal fluid (CSF) drainage pathway, and an therefore intended to stabilise intracranial pressure (ICP) at a level close to the shunt's operating pressure. However, this goal cannot always be attained. Accelerated CSF drainage with vertical body posture in ventriculo-peritoneal shunts is one reason for the ICP decreasing below the shunt's operating pressure. Another possible factor has been studied: the impact of the pulsating pattern in the ICP on the operating pressure. Six popular constructions of medium-pressure valves were studied (Radionics Low-profile, Delta, Hakim Precision, Holter, Integra In-line and Hakim NMT). Valves were mounted in the testing rig in the UK. Shunt Evaluation Laboratory and perfused with de-ionised water at a rate of 0.3 ml min(-1), and proximal pulsating pressures of different amplitudes (from 2 to 30mmHg peak-to-peak) and frequencies (70-10 cycles min(-1)) were superimposed. Laboratory findings were compared with clinical material containing recordings of ICP made in patients to diagnose reasons for ventriculomegaly. The mean operating pressure decreased in all valves when the simulated amplitude of heart pulsations increased. The rate of this decrease was dependent on the type of valve (variable from 2.5 to 5 mm Hg per increase in peak-to-peak amplitude by 10 mm Hg). The decrease was not related to the frequency of the wave. The relationship between pulse amplitude and ICP in 35 patients with blocked shunts was strong (R = 0.48; p < 0.03; slope 0.14) and in 25 patients with properly functioning shunts was non-significant (R = 0.057; p = 0.765). Two examples of decrease in mean ICP in the presence of increased vasogenic ICP waves in shunted patients are presented. The shunt operating pressure, which 'sets' the ICP in shunted patients may be influenced by the dynamics of a patient's ICP waveform. [ABSTRACT FROM AUTHOR]

: Copyright of Medical & Biological Engineering & Computing is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Freimann, Florian Baptist¹, Sprung, Christian¹, Chopra, Sascha Santosh¹, Vajkoczy, Peter¹, Wolf, Stefan¹

المصدر: Pediatric Neurosurgery. Dec2013, Vol. 49 Issue 1, p29-32. 4p. 2 Black and White Photographs, 1 Graph.

مصطلحات موضوعية: *HYDROCEPHALUS, *INTRACRANIAL pressure, *CEREBROSPINAL fluid pressure, *TELEMETRY, *BRAIN disease research

مستخلص: The Neurovent-P-tel sensor is a promising device for telemetric intracranial pressure (ICP) measurements in cases of complex hydrocephalus. Data on its accuracy within a broad ICP range are missing. We applied a porcine model for large-scale manipulation of the ICP values. The telemetric ICP sensor was referenced against ICP values measured directly from a water column within a riser tube. A total of 34 comparative ICP measurements within an ICP range from 2 cm H2O to 31 mm Hg were performed. The mean difference between both measurement techniques was 0.4 mm Hg. The limits of agreement, where 95% of differences between both methods are expected, were from -2.4 to 3.1 mm Hg. The telemetric Neurovent-P-tel sensor system provides good accuracy within a broad range exceeding normal ICP values and might be useful in clinical practice. © 2013 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

المؤلفون: Rehman, Zia ur¹ zia127@yahoo.com, Khanzada, Khalid¹, Husain, Ramzan¹, Ali, Mumtaz¹, Ali, Mohammad¹

المصدر: JPMI: Journal of Postgraduate Medical Institute. 2013, Vol. 27 Issue 4, p433-438. 6p.

مصطلحات موضوعية: *HYDROCEPHALUS, *BRAIN disease treatment, *INTRACRANIAL pressure, *CEREBROSPINAL fluid pressure, *BODY fluid pressure

مستخلص: Objective: To analyze the outcome of endoscopic 3rd ventriculotomy in the management of hydrocephalus secondary to posterior fossa tumor. Methodology: Sixty five cases of hydrocephalus secondary to posterior fossa tumor underwent endoscopic 3rd ventriculostomy in the Department of Neurosurgery, Lady Reading Hospital, Peshawar Pakistan from January, 2011 to June, 2012 (18 months). This was an observational study and the sampling was by simple random method. Results: The study included 65 patients (37 males, 28 females); M/F ratio was 1.32; Age range was 1-45 years. Fifty one percent (33 cases) of posterior fossa tumors occurred in children less than five years, 23% (15 cases) in the 6-10 year age group, 16% (11 cases) occurred in 11-14 years and 10% (06 cases) in age group >14 yrs. Endoscopic third ventriculostomy was performed in 54 (83.07%) patients with successful outcome. Ventriculoperitoneal shunt was required in 5 (7.69%) patients for the suspicion of inadequate ventriculostomy. Ventricular drainage device (EVD) was inserted in 2 (3.07%) cases for hemorrhagic CSF. In 4 (6.15%) patients no drainage procedure was done (4th ventricle floor not involved / Aqueduct opening visible). Conclusions: Preoperative endoscopic third ventriculostomy (ETV) control the intracranial pressure (ICP), avoid the necessity of an emergency procedure, allow appropriate scheduling of the operation for tumor removal, and eliminate the risks related to the presence of an external drainage. The most common age group involved was under 5 years. The success rate of ETV was 83% and Medulloblastoma was the most common Histopathological findings. [ABSTRACT FROM AUTHOR]

المؤلفون: Akins, Paul¹ akins@surewest.net, Guppy, Kern¹, Axelrod, Yekaterina¹, Chakrabarti, Indro¹, Silverthorn, James¹, Williams, Alan¹

المصدر: Neurocritical Care. Dec2011, Vol. 15 Issue 3, p461-468. 8p.

مصطلحات موضوعية: *HYDROCEPHALUS, *BRAIN diseases, *INTRACRANIAL pressure, *CEREBROSPINAL fluid pressure, *SUBARACHNOID hemorrhage

مستخلص: Background: Low pressure hydrocephalus (LPH) is an uncommon entity. Recognition of this treatable condition is important when clinicians are faced with the paradox of symptomatic hydrocephalus despite low intracranial pressures (ICP). Its etiology remains enigmatic. Methods: We identified patients with LPH from the prospective, inpatient neuro-intensive care database over a 4-year period (2006-2010). Results: Nine patients with LPH were identified over a 4-year period. The time from diagnosis of the initial neurosurgical condition to development of LPH varied from 7 days to 5 years. The sub-zero drainage method of Pang and Altschuler was successful in all cases. LPH was accompanied by transependymal edema in five patients despite low ICP. Four patients developed LPH during their initial admission for intracranial bleeding. As patients entered the LPH state, the ICP remained in a normal range yet daily CSF output from the external ventricular drain was reduced. When LPH patients were drained at sub-zero levels, daily CSF output exceeded baseline values for several days and then receded to baseline. Long-term management was achieved with low pressure shunt systems: six programmable shunts; one valveless ventriculoperitoneal shunt; two ventriculopleural shunts. Conditions most commonly associated with LPH are: subarachnoid hemorrhage, chronic hydrocephalus, brain tumors, and chronic CNS infections. Conclusions: Low pressure hydrocephalus is a challenging diagnosis. The genesis of LPH was associated with a drop in EVD output, symptomatic ventriculomegaly, and a remarkable absence of intracranial hypertension. When LPH was treated with the sub-zero method, a 'diuresis' of CSF ensued. These observations support a Darcy's flux of brain interstitial fluid due to altered brain poroelastance; in simpler terms, a boggy brain state. [ABSTRACT FROM AUTHOR]

المؤلفون: Anthony Podgoršak, Nina Eva Trimmel, Markus Florian Oertel, Sara Qvarlander, Margarete Arras, Anders Eklund, Miriam Weisskopf, Marianne Schmid Daners

المساهمون: University of Zurich, Schmid Daners, Marianne

المصدر: Fluids and Barriers of the CNS, Vol 19, Iss 1, Pp 1-13 (2022)
Fluids and Barriers of the CNS
Fluids and Barriers of the CNS, 19 (1)

مصطلحات موضوعية: Neurologi, Intracranial pressure, 2804 Cellular and Molecular Neuroscience, 610 Medicine & health, Sheep model, Subarachnoid Space, Cerebrospinal fluid, Bolus infusion, Constant pressure infusion, Hydrocephalus, Intrathecal pressure, Cellular and Molecular Neuroscience, 10180 Clinic for Neurosurgery, 2806 Developmental Neuroscience, Developmental Neuroscience, Cerebrospinal Fluid Pressure, Animals, Arterial Pressure, Infusions, Spinal, RC346-429, Sheep, Research, General Medicine, Neurology, 2808 Neurology, Neurology. Diseases of the nervous system, Venous Pressure

الوصف: Introduction: The treatment of hydrocephalus has been a topic of intense research ever since the first clinically successful use of a valved cerebrospinal fluid shunt 72 years ago. While ample studies elucidating different phenomena impacting this treatment exist, there are still gaps to be filled. Specifically, how intracranial, intrathecal, arterial, and venous pressures react and communicate with each other simultaneously. Methods: An in-vivo sheep trial (n = 6) was conducted to evaluate and quantify the communication existing within the cranio-spinal, arterial, and venous systems (1 kHz sampling frequency). Standardized intrathecal infusion testing was performed using an automated infusion apparatus, including bolus and constant pressure infusions. Bolus infusions entailed six lumbar intrathecal infusions of 2 mL Ringer’s solution. Constant pressure infusions were comprised of six regulated pressure steps of 3.75 mmHg for periods of 7 min each. Mean pressure reactions, pulse amplitude reactions, and outflow resistance were calculated. Results: All sheep showed intracranial pressure reactions to acute increases of intrathecal pressure, with four of six sheep showing clear cranio-spinal communication. During bolus infusions, the increases of mean pressure for intrathecal, intracranial, arterial, and venous pressure were 16.6 ± 0.9, 15.4 ± 0.8, 3.9 ± 0.8, and 0.1 ± 0.2 mmHg with corresponding pulse amplitude increases of 2.4 ± 0.3, 1.3 ± 0.3, 1.3 ± 0.3, and 0.2 ± 0.1 mmHg, respectively. During constant pressure infusions, mean increases from baseline were 14.6 ± 3.8, 15.5 ± 4.2, 4.2 ± 8.2, and 3.2 ± 2.4 mmHg with the corresponding pulse amplitude increases of 2.5 ± 3.6, 2.5 ± 3.0, 7.7 ± 4.3, and 0.7 ± 2.0 mmHg for intrathecal, intracranial, arterial, and venous pulse amplitude, respectively. Outflow resistances were calculated as 51.6 ± 7.8 and 77.8 ± 14.5 mmHg/mL/min for the bolus and constant pressure infusion methods, respectively—showing deviations between the two estimation methods. Conclusions: Standardized infusion tests with multi-compartmental pressure recordings in sheep have helped capture distinct reactions between the intrathecal, intracranial, arterial, and venous systems. Volumetric pressure changes in the intrathecal space have been shown to propagate to the intraventricular and arterial systems in our sample,and to the venous side in individual cases. These results represent an important step into achieving a more complete quantitative understanding of how an acute rise in intrathecal pressure can propagate and influence other systems.
Fluids and Barriers of the CNS, 19 (1)
ISSN:2045-8118

وصف الملف: Podgorsak-2022-Intercompartmental_communicatio.pdf - application/pdf; application/pdf; application/application/pdf

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::7d62fa711261f5fc78d37de631962339Test
https://doaj.org/article/09a62ed7e3a44fc8bdb0c0382a8974caTest

العنوان البديل: Benign but not harmless intracranial hypertension: A case report

المؤلفون: Duclos, C.¹, Bonnin, N.², Merlin, E.¹ e_merlin@chu-clermontferrand.fr, Viorel, A.³, Lacombe, P.¹, Dalens, H.², Chiambaretta, F.², Deméocq, F.¹, Chazal, J.³, Kanold, J.¹

المصدر: Archives de Pédiatrie. Dec2010, Vol. 17 Issue 12, p1677-1681. 5p.

مصطلحات موضوعية: *INTRACRANIAL pressure, *HYDROCEPHALUS, *SINUS thrombosis, *PROGNOSIS, *CEREBROSPINAL fluid pressure, *ACETAZOLAMIDE

الملخص (بالإنجليزية): Summary: Benign intracranial hypertension (BIH) is characterized as an intracranial pressure increase occurring in the absence of brain tumour, sinus thrombosis or hydrocephaly. But contrary to what its designation might suggest, it threatens the visual prognosis. We report the case of a 15-year-old girl with lymphocytic meningitis, developing secondary a BIH. Cerebrospinal fluid pressure was 70cm water, without enlargement of the cerebral ventricles. Along with the progression, bilateral 6th nerve palsy, impairment of visual acuity and bilateral papilledema appeared. No cause was found after a complete assessment. Treatment consisted in oral acetazolamide and 9 depletive spinal taps. Clinical examination, fundus examination and Goldmann visual field normalized after 8 weeks. No relapse occurred after a 1-year follow-up. This case shows that BIH, which is not a well-known disorder, is incorrectly referred to as benign: both prompt diagnosis and proper management are of major importance. [Copyright &y& Elsevier]

Abstract (French): Résumé: L’hypertension intracrânienne bénigne (HICB) est caractérisée par une augmentation de la pression intracrânienne en l’absence de processus expansif intracrânien, de thrombose veineuse ou d’hydrocéphalie. Contrairement à ce que pourrait laisser penser son appellation, elle met en jeu le pronostic visuel. Nous rapportons le cas d’une jeune fille de 15 ans qui a présenté un tableau initial compatible avec une méningite virale, bien qu’il n’ait pas comporté de syndrome méningé franc. La pression du liquide céphalorachidien (LCR) était de 70cm d’eau. Il n’existait pas de dilatation ventriculaire. L’évolution était marquée par une atteinte du nerf abducens (VI), une baisse d’acuité visuelle et un œdème papillaire bilatéral. Le diagnostic retenu était celui d’HICB secondaire, de cause inconnue malgré un bilan exhaustif. Après 8 semaines de traitement par acétazolamide per os et un traitement par ponctions lombaires itératives, l’évolution était favorable. Il n’y a pas eu de récidive après 1 an de recul. Cette observation illustre les risques liés à une affection peu connue et improprement dénommée bénigne, dont la prise en charge symptomatique et étiologique est primordiale pour la préservation de la fonction visuelle.

المؤلفون: Nagra, Gurjit¹, Koh, Lena¹, Aubert, Isabelle¹, Minhui Kim¹, Johnston, Miles¹ miles.johnston@sunnybrook.ca

المصدر: American Journal of Physiology: Regulatory, Integrative & Comparative Physiology. Nov2009, Vol. 297, pR1312-R1321. 10p.

مصطلحات موضوعية: *HYDROCEPHALUS, *INTRACRANIAL pressure, *EXTRACELLULAR fluid, *BRAIN diseases, *IMMUNOGLOBULINS, *INTEGRINS, *LABORATORY rats, *INTRAVENTRICULAR injections

مستخلص: In some tissues, the injection of antibodies to the β1-integrins leads to a reduction in interstitial fluid pressure, indicating an active role for the extracellular matrix in tissue pressure regulation. If perturbations of the matrix occur in the periventricular area of the brain, a comparable lowering of interstitial pressures may induce transparenchymal pressure gradients favoring ventricular expansion. To examine this concept, we measured periventricular (parenchymal) and ventricular pressures with a servo-null micropipette system (2-μm tip) in adult Wistar rats before and after anti-integrin antibodies or IgG/IgM isotype controls were injected into a lateral ventricle. In a second group, the animals were kept for 2 wk after similar injections and after euthanization, the brains were removed and assessed for hydrocephalus. In experiments in which antibodies to β1-integrins (n = 10) but not isotype control IgG/IgM (n = 7) were injected, we observed a decline in periventricular pressures relative to the preinjection values. Under similar circumstances, ventricular pressures were elevated (n = 10) and were significantly greater than those in the periventricular interstitium. We estimated ventricular to periventricular pressure gradients of up to 4.3 cmH2O. In the chronic preparations, we observed enlarged ventricles in many of the animals that received injections of anti-integrin antibodies (21 of 29 animals; 72%) but not in any animal receiving the isotype controls. We conclude that modulation/disruption of β1integrin-matrix interactions in the brain generates pressure gradients favoring ventricular expansion, suggesting a novel mechanism for hydrocephalus development. [ABSTRACT FROM AUTHOR]