Summary
Twelve patients presenting with communicating hydrocephalus were studied. In 9 cases where the mean ICP level remained below 10mmHg the symptoms of normal pressure hydrocephalus were observed. All of the patients were treated by shunt system implantation. The clinical and psychological state, cranial computerized tomography and parameters of the cerebrospinal compensatory mechanisms, evaluated using the constant rate infusion test were compared before and after treatment.
In most of the patients (11) the pathologically enlarged ventricles persisted. Only in three cases no clinical improvement was noticed. In this group the resistance to the cerebrospinal fluid absorption and the fluid formation rate were estimated as normal. In the group with improvement the normalization of the resistance (4), decrease in the cerebrospinal fluid formation rate (4) and decrease in the cerebrospinal system elasticity (1) can be pointed out as factors responsible for improvement manifested after shunting.
Therefore the resorption resistance and the formation of cerebrospinal fluid should be considered as predictive factors in the shunt implantation in hydrocephalic patients, and play an important role in the diagnosis of this entity.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Belloni G, Rocco C, Focacci C, Galli G, Maira G, Rossi GF (1976) Surgical indications in normotensive hydrocephalus. A retrospective analysis of the relations of some diagnostic findings to the results of surgical treatment. Acta Neurochir (Wien) 33: 1–21
BØrgensen SE, Gjerris F, SØrensen SC (1979) Intracranial pressure and conductance to otflow of cerebrospinal fluid in normal pressure hydrocephalus. J Neurosurg 50: 489–493
BØrgensen SE, Gjerris F (1982) The predictive value of conductance to outflow of CSF in normal pressure hydrocephalus. Brain 105: 65–86
Czosnyka M, Duda M, Darwaj P, Zaworski W, Laniewski P, Batorski L (1988) Software for neurosurgery and intensive care for IBM PC. VII Symposium on Intracranial Pressure and Brain Injury (in press)
Gjerris F (1988) Hydrocephalus—definition and classification, European Course in Neurosurgery—Amsterdam, Materials, pp 203–206
Kosteljanetz M, Ingstrup H (1985) Normal pressure hydrocephalus-correlation between CT and measurement of CSF dynamics. Acta Neurochir (Wien) 77: 8–13
McComb JG (1983) Recent research into the nature of cerebrospinal fluid formation and absorption. J Neurosurg 59: 369–383
Shenkin HA, Greenberg JO, Grossman CB (1975) Ventricular size after shunting for idiopathic normal pressure hydrocephalus. J Neurol Neurosurg Psychiatry 38: 833–837
Szewczykowski J, Kunicki A, Sliwka S, Korsak-Sliwka J, Pawlowski G, Dziduszko J, Grochowski W, Augustyniak B (1982) CSF absorptive capacity in patients without intracranial pathology. Zbl Neurochirurgie 43: 43–48
Vasilouthis J (1984) The syndrome of normal pressure hydrocephalus. J Neurosurg 61: 501–509
Woodford J, Saunders RL, Sachs E Jr (1976) Shunt system patency testing by lumbar infusion. J Neurosurg 45: 60–65
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Maksymowicz, W., Czosnyka, M., Koszewski, W. et al. The role of cerebrospinal compensatory parameters in the estimation of functioning of implanted shunt system in patients with communicating hydrocephalus (preliminary report). Acta neurochir 101, 112–116 (1989). https://doi.org/10.1007/BF01410524
Issue Date:
DOI: https://doi.org/10.1007/BF01410524