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CSF shunt physics: factors influencing inshunt CSF flow

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Abstract

Cerebrospinal fluid (CSF) in a shunt does not have a constant flow rate. The flow fluctuates from 0.01 ml/min to 1.93 ml/min according to each patient's own daily supine rhythmic pattern. We determined and evaluated the factors influencing CSF flow in a shunt in 19 cases of hydrocephalus. Postural changes, such as head elevation, led to increases by over 0.04 ml/min in inshunt CSF flow, while inshunt CSF flow in the supine position was less than 0.04 ml/min. Respiratory changes, such as coughing and apnea-hyperventilation, also influenced inshunt CSF flow. Changes in intracranial pressure (ICP) corresponded to changes in inshunt CSF flow. Inshunt CSF flows were higher than average during the night, the flows being stimulated by increases in ICP especially during REM sleep.

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References

  1. Castillo M, Hudgins PA, Malko JA, Burrow BK, Hoffmann JC (1991) Flow-sensitive MR imaging of ventriculoperitoneal shunts: in vitro findings, clinical application, and pitfalls. AJNR 12:667–671

    Google Scholar 

  2. Chiba Y, Iwashita Y, Suzuki N, Muramoto M, Kunimi Y (1985) Thermosensitive determination of obstructed sites in ventriculoperitoneal shunts. J Neurosurg 62:363–366

    Google Scholar 

  3. Cutler RWP, Page L, Galicich J, Watters GV (1968) Formation and absorption of cerebrospinal fluid in man. Brain 91:707–720

    Google Scholar 

  4. Di Chiro G, Grove AS (1966) Evaluation of surgical and spontaneous cerebrospinal fluid shunts by isotope scanning. J Neurosurg 24:743–758

    Google Scholar 

  5. Durward QJ, Amacher AL, Del Maestro RF, Sibbald WJ (1983) Cerebral and cardiovascular responses to changes in head elevation in patients with intracranial hypertension. J Neurosurg 59: 938–944

    Google Scholar 

  6. Flitter MA, Bucheheit WA, Murtagh F, Lapayowker MS (1975) Ultrasound determination of cerebrospinal fluid shunt patency. J Neurosurg 42:728–730

    Google Scholar 

  7. Frank E, Buonocore M, Hein L (1990) The use of magnetic resonance imaging to assess slow fluid flow in a model cerebrospinal fluid shunt system. Br J Neurosurg 4:53–58

    Google Scholar 

  8. Go KG, Melchior HJ, Lakke JPWF (1968) A thermosensitive device for the evaluation of the patency of ventriculo-atrial shunts in hydrocephalus. Acta Neurochir 19:209–216

    Google Scholar 

  9. Hara M, Kadawaki C, Konishi Y, Ogashiwa M, Numoto M, Takeuchi K (1983) A new method for measuring cerebrospinal fluid flow in shunts. J Neurosurg 58:557–561

    Google Scholar 

  10. Howman-Giles R, McLaughlin A, Johnston I, Whittle I (1984) A radionuclide method of evaluating shunt function and CSF circulation in hydrocephalus. J Neurosurg 61:604–605

    Google Scholar 

  11. Kadowaki C, Hara M, Numoto M, Takeuchi K (1986) CSF circulation in hydrocephalus: a study of CSF flow in a shunt system. In: Miller JD, Teasdale GM, Rowan JO (eds) Intracranial pressure VI. Springer, Berlin Heidelberg New York, pp 423–427

    Google Scholar 

  12. Kadowaki C, Hara M, Numoto M, Takeuchi K (1987) Factors affecting cerebrospinal fluid flow in a shunt. Br J Neurosurg 1:467–475

    Google Scholar 

  13. Lorenzo AV, Page LK, Watters GV (1970) Relationship between cerebrospinal fluid formation, absorption and pressure in human hydrocephalus. Brain 93:679–692

    Google Scholar 

  14. Matsumae M, Murakami T, Ueda M, Suzuki Y, Sato O (1987) Dynamic changes of cerebrospinal fluid shunt flow in patient's daily life. Child's Nerv Syst 3:30–34

    Google Scholar 

  15. Numoto M, Hara M, Sakai T, Kadowaki C, Takeuchi K (1984) A non-invasive CSF flowmeter. J Med Eng Tech 8:218–220

    Google Scholar 

  16. Portnoy HD, Tripp L, Croissant PD (1976) Hydrodynamics of shunt valves. Child's Brain 2:242–256

    Google Scholar 

  17. Raimondi AJ (1988) Shunts, indications, problems and characteristics. Child's Nerv Syst 4:321–324

    Google Scholar 

  18. Stein SC, Apfel S (1981) A noninvasive approach to quantitative measurement of flow through CSF shunts. J Neurosurg 54:556–558

    Google Scholar 

  19. Urlesberger B, Müller W, Ritschl E, Reiterer F (1991) The influence of head position on the intracranial pressure in preterm infants with posthemorrhagic hydrocephalus. Child's Nerv Syst 7:85–87

    Google Scholar 

  20. Yamada S, Ducker TB, Perot PL (1975) Dynamic changes of cerebrospinal fluid in upright and recumbent shunted experimental animals. Child's Brain 1:187–192

    Google Scholar 

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Kadowaki, C., Hara, M., Numoto, M. et al. CSF shunt physics: factors influencing inshunt CSF flow. Child's Nerv Syst 11, 203–206 (1995). https://doi.org/10.1007/BF00277654

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