期刊
PHYSIOLOGICAL MEASUREMENT
卷 31, 期 11, 页码 1517-1528出版社
IOP PUBLISHING LTD
DOI: 10.1088/0967-3334/31/11/008
关键词
normal pressure hydrocephalus; pulse pressure; amplitudes; cerebrospinal fluid pressure; intracranial pressure; infusion test; arterial pulsations
资金
- VR
- VINNOVA
- SSF
- EU through ERDF
The amplitude of cardiac-related pulsations in intracranial pressure has recently been suggested as useful for selecting patients for shunt surgery in hydrocephalus. To better understand how shunting affects these pulsations, we aim to model the relationship between mean pressure and pulsation amplitude in a wide range, including low pressures typically found after shunt surgery. Twenty-five patients with probable idiopathic normal pressure hydrocephalus were examined with lumbar constant pressure infusion investigations including drainage of cerebrospinal fluid. Mean pressure and pulsation amplitude were determined for consecutive 1.5 s intervals, starting at peak pressure (ca 35 mmHg), after infusion, continuing during spontaneous return to baseline and drainage to 0 mmHg. The amplitude versus pressure relationship revealed a linear phase at higher pressures (14-32 mmHg, lack of fit test: p = 0.79), a transitional phase and an essentially constant phase at low pressures (0-10 mmHg, slope = -0.02, lack of fit test: p = 0.88). Individual patients' baseline values were found in all three phases. The model and methodology presented in this paper can be used to preoperatively identify patients with potential for postoperative amplitude decrease and to predict how much the amplitude can be reduced.
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