دورية أكاديمية
Cerebrospinal fluid dynamics in non-acute post-traumatic ventriculomegaly.
| العنوان: | Cerebrospinal fluid dynamics in non-acute post-traumatic ventriculomegaly. |
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| المؤلفون: | Lalou, Afroditi D, Levrini, Virginia, Czosnyka, Marek, Gergelé, Laurent, Garnett, Matthew, Kolias, Angelos, Hutchinson, Peter J, Czosnyka, Zofia |
| بيانات النشر: | Springer Science and Business Media LLC //dx.doi.org/10.1186/s12987-020-00184-6 Fluids Barriers CNS |
| سنة النشر: | 2020 |
| المجموعة: | Apollo - University of Cambridge Repository |
| مصطلحات موضوعية: | CSF dynamics, CSF infusion test, Cerebrospinal fluid, Hydrocephalus, Traumatic brain injury, Ventriculomegaly, Adult, Aged, Brain Injuries, Traumatic, Female, Humans, Normal Pressure, Hydrodynamics, Intracranial Pressure, Male, Middle Aged, Retrospective Studies |
| 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: | Electronic; application/pdf |
| اللغة: | English |
| العلاقة: | https://www.repository.cam.ac.uk/handle/1810/305906Test |
| DOI: | 10.17863/CAM.52984 |
| الإتاحة: | https://doi.org/10.17863/CAM.52984Test https://www.repository.cam.ac.uk/handle/1810/305906Test |
| حقوق: | Attribution 4.0 International ; https://creativecommons.org/licenses/by/4.0Test/ |
| رقم الانضمام: | edsbas.A55D7E1 |
| قاعدة البيانات: | BASE |
| DOI: | 10.17863/CAM.52984 |
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