Clinical testing of CSF circulation

• Published in: European journal of anaesthesiology Vol. 25; no. S42; pp. 142 - 145
• Main Authors: Czosnyka, Z., Czosnyka, M., Lavinio, A., Keong, N., Pickard, J. D.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01-02-2008; European Society of Anaesthesiology; Lippincott Williams & Wilkins Ovid Technologies
• Subjects: Aged; Algorithms; Cerebrospinal Fluid Pressure; Cerebrospinal Fluid Shunts - instrumentation; Cerebrovascular Circulation; Female; Humans; Hydrocephalus, Normal Pressure - cerebrospinal fluid; Hydrocephalus, Normal Pressure - diagnosis; Hypodermic needles; Intracranial Pressure; Medical diagnosis; Nervous System Diseases - cerebrospinal fluid; Nervous System Diseases - diagnosis; Patients; Pressure; Pressure measurement; Signal Processing, Computer-Assisted; Software; Temperature; Time Factors; INTRACRANIAL PRESSURE; FLUID DYNAMICS; CEREBROSPINAL FLUID; HYDROCEPHALUS
• ISSN: 0265-0215; 0952-1941; 1365-2346
• DOI: 10.1017/S0265021507003249

Since shunting is almost a purely mechanical treatment that radically affects pressure–volume compensation, patients’ cerebrospinal fluid hydrodynamics compensation should be examined before a shunt is implanted. Apart from an opening pressure and a resistance to cerebrospinal fluid outflow, pulse amplitude of intracranial pressure and the content of vasogenic waves are useful to gauge cerebrospinal fluid dynamics. Infusion studies, although invasive, may help with the decision about surgery. They also provide basic information for further management of shunted patients, when complications, such as shunt blockage, under- and over-drainage, arise.