Summary
Objective
Previously, we documented association between CSF circulation and transcranial-Doppler derived autoregulation in non-shunted patients suffering from hydrocephalus. In the present study we sought to investigate the relationship between the resistance to CSF outflow and pressure-reactivity both in shunted and non-shunted NPH patients.
Material and methods
Sixty-eight patients (47 non-shunted and 21 shunted) with NPH have been examined as a part of routine diagnostic procedure. Resistance to CSF outflow (Rcsf) was measured using a ventricular constant rate infusion test. Cerebrovascular pressure-reactivity was assessed as a moving correlation coefficient (PRx) between coherent ‘slow waves’ of ICP and arterial blood pressure (ABP). This variable has previously been demonstrated to correlate with the autoregulation of CBF in patients following head injury.
Results
In non-shunted patients cerebrovascular pressure-reactivity (PRx) was negatively correlated with Rcsf (R = −0.5; p < 0.0005). This relationship was inverted in shunted patients: a positive correlation between PRx and Rcsf was found (R = 0.51; p < 0.03).
Conclusion
Cerebrovascular pressure-reactivity is disturbed in patients with normal resistance to CSF outflow, suggesting underlying cerebrovascular disease. This result confirms our previous finding where transcranial Doppler autoregulation was investigated. After shunting the pressure-reactivity strongly depends on shunt functioning and deteriorates when the shunt is blocked.
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© 2005 Springer-Verlag
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Czosnyka, Z., van den Boogaard, F., Czosnyka, M., Momjian, S., Gelling, L., Pickard, J.D. (2005). The relationship between CSF circulation and cerebrovascular pressure-reactivity in normal pressure hydrocephalus. In: Poon, W.S., et al. Intracranial Pressure and Brain Monitoring XII. Acta Neurochirurgica Supplementum, vol 95. Springer, Vienna. https://doi.org/10.1007/3-211-32318-X_43
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DOI: https://doi.org/10.1007/3-211-32318-X_43
Publisher Name: Springer, Vienna
Print ISBN: 978-3-211-24336-7
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