دورية أكاديمية

Cerebrospinal fluid dynamics in non-acute post-traumatic ventriculomegaly.

التفاصيل البيبلوغرافية
العنوان: Cerebrospinal fluid dynamics in non-acute post-traumatic ventriculomegaly.
المؤلفون: Lalou, Afroditi D, Levrini, Virginia, Czosnyka, Marek, Gergelé, Laurent, Garnett, Matthew, Kolias, Angelos, Hutchinson, Peter J, Czosnyka, Zofia
المصدر: essn: 2045-8118 ; nlmid: 101553157
بيانات النشر: Fluids and barriers of the CNS
سنة النشر: 2020
المجموعة: Apollo - University of Cambridge Repository
مصطلحات موضوعية: Cerebrospinal fluid, Traumatic brain injury, Hydrocephalus, Ventriculomegaly, Csf Dynamics, Csf Infusion Test
الوصف: BACKGROUND:Post-traumatic hydrocephalus (PTH) is potentially under-diagnosed and under-treated, generating the need for a more efficient diagnostic tool. We aim to report CSF dynamics of patients with post-traumatic ventriculomegaly. MATERIALS AND METHODS:We retrospectively analysed post-traumatic brain injury (TBI) patients with ventriculomegaly who had undergone a CSF infusion test. We calculated the resistance to CSF outflow (Rout), AMP (pulse amplitude of intracranial pressure, ICP), dAMP (AMPplateau-AMPbaseline) and compensatory reserve index correlation coefficient between ICP and AMP (RAP). To avoid confounding factors, included patients had to be non-decompressed or with cranioplasty > 1 month previously and Rout > 6 mmHg/min/ml. Compliance was assessed using the elasticity coefficient. We also compared infusion-tested TBI patients selected for shunting versus those not selected for shunting (consultant decision based on clinical and radiological assessment and the infusion results). Finally, we used data from a group of shunted idiopathic Normal Pressure Hydrocephalus (iNPH) patients for comparison. RESULTS:Group A consisted of 36 patients with post-traumatic ventriculomegaly and Group B of 45 iNPH shunt responders. AMP and dAMP were significantly lower in Group A than B (0.55 ± 0.39 vs 1.02 ± 0.72; p < 0.01 and 1.58 ± 1.21 vs 2.76 ± 1.5; p < 0.01. RAP baseline was not significantly different between the two. Elasticity was higher than the normal limit in all groups (average 0.18 1/ml). Significantly higher Rout was present in those with probable PTH selected for shunting compared with unshunted. Mild/moderate hydrocephalus, ex-vacuo ventriculomegaly/encephalomalacia were inconsistently reported in PTH patients. CONCLUSIONS:Rout and AMP were significantly lower in PTH compared to iNPH and did not always reflect the degree of hydrocephalus or atrophy reported on CT/MRI. Compliance appears reduced in PTH.
نوع الوثيقة: article in journal/newspaper
وصف الملف: application/pdf
اللغة: English
العلاقة: https://www.repository.cam.ac.uk/handle/1810/304947Test
DOI: 10.17863/CAM.52025
الإتاحة: https://doi.org/10.17863/CAM.52025Test
https://www.repository.cam.ac.uk/handle/1810/304947Test
حقوق: Attribution 4.0 International ; https://creativecommons.org/licenses/by/4.0Test/
رقم الانضمام: edsbas.A1824516
قاعدة البيانات: BASE