Effect of respiratory movement on cerebrospinal fluid dynamics in hydrocephalic infants with shunts.

The authors report a study of the effect of respiratory movement on intracranial, auricular, and intraperitoneal cerebrospinal fluid (CSF) pressure in hydrocephalic infants with shunts. Postoperative intraventricular pressures were also recorded for comparison. The intraventricular, right auricular, and intraperitoneal pressures rose during expiration and dropped during inspiration; the pressure changes were most marked while the infants were crying or straining. All pressures dropped simultaneously at the time of inspiration, but the auricular pressure was most significantly affected. It dropped to -100 to -200 mm H2O when the patients cried, while intraventricular and intraperitoneal pressures remained above O mm H2O. The postoperative intracranial pressures were in accord with these results; the pressures after ventriculoatrial shunt were significantly lower than those after ventriculoperitoneal shunt when the same pressure valves were used.