Abstract:
OBJECTIVES:The lumbar infusion test is an invasive technique for quantifying cerebrospinal dynamics in patients with hydrocephalus. However, some patients have difficulty tolerating the duration of this procedure. Therefore, we investigated the limits of shortening the test by examining the reliability of cerebrospinal fluid (CSF) compensatory parameters as a function of time. METHODS:We analysed recordings of the intracranial cerebral pressure (ICP) response to a constant, high-rate infusion of saline (2 ml/min) lasting 5.7-20 (12 ± 10) min in 30 patients with a preliminary diagnosis of hydrocephalus (13 men, aged 37-81 [65 ± 10] years). We performed computerised identification of CSF outflow resistance (R(out)), intracranial compliance parameters: elastance index (E) and reference pressure (P(0)), based on the truncated ICP response (20-100% of the available test length), estimating either all three parameters (3p method) or only R(out) and E (2p method) assuming P(0) as the regression between the ICP and its amplitude. RESULTS:Following considerable variation during the initial rise of ICP, R(out) typically converged within ± 10% of their final values within 10-15 min. Final R(out) values were 4-40 (12 ± 6) mmHg/ml/min, and were method independent (R(2) = 0.97). Compliance parameters (E, typically 0.1-0.5/ml; P(0): - 10 to + 20 mmHg) agreed poorly between methods (R(2) = 0.3-0.7) and varied considerably within the observed infusion periods. CONCLUSION:The lumbar infusion test may be shortened to 10-15 min using a rapid infusion rate of 2 ml/min that fulfils the primary objective of obtaining reliable estimates of R(out). This may benefit patients who do not tolerate the full procedure.
journal_name
Br J Neurosurgjournal_title
British journal of neurosurgeryauthors
Piechnik SK,Ferreira VM,Cieslicki Kdoi
10.3109/02688697.2011.591848subject
Has Abstractpub_date
2012-02-01 00:00:00pages
38-44issue
1eissn
0268-8697issn
1360-046Xjournal_volume
26pub_type
杂志文章abstract::Angiographic middle and anterior cerebral artery diameter and transcranial ultrasound flow velocity measurements were performed within 24 h of each other in 102 patients with recent aneurysmal subarachnoid haemorrhage. There was a significant inverse correlation between middle cerebral artery diameter and flow velocit...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688699309023812
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