Czosnyka Marek, Czosnyka Zofia, Momjian Shahan, Pickard John D
Department of Neurosciences, Addenbrooke's Hospital, Cambridge, UK.
Physiol Meas. 2004 Oct;25(5):R51-76. doi: 10.1088/0967-3334/25/5/r01.
Hydrocephalus is far more complicated than a simple disorder of CSF circulation. Historically, it has been diagnosed using clinical and psychomotor assessment plus brain imaging. The role of physiological measurement to aid diagnosis becomes more appreciated in current clinical practice. This has been reflected by recently formulated guidelines for the management of normal pressure hydrocephalus. Clinical measurement in hydrocephalus is mainly related to intracranial pressure (ICP) and cerebral blood flow. This review lists and discusses most common forms of the methods: CSF infusion study, overnight ICP monitoring, assessment of slow ICP waves, testing pressure reactivity, cerebral autoregulation, CO2 reactivity and PET-CBF studies combined with MRI co-registration. The basics of CSF dynamics modelling are presented and the principles of the assessment of functioning of the implanted hydrocephalus shunts are also discussed. The descriptions of multiple forms of measurement along with clinical illustrations are mainly based on in-house experience of a multidisciplinary group of scientists and clinicians from Cambridge, UK.
脑积水远比单纯的脑脊液循环紊乱复杂得多。从历史上看，它是通过临床和精神运动评估以及脑成像来诊断的。在当前的临床实践中，生理测量对辅助诊断的作用越来越受到重视。这一点在最近制定的正常压力脑积水管理指南中得到了体现。脑积水的临床测量主要与颅内压（ICP）和脑血流量有关。本综述列出并讨论了这些方法最常见的形式：脑脊液灌注研究、夜间ICP监测、慢ICP波评估、压力反应性测试、脑自动调节、二氧化碳反应性以及PET-CBF研究与MRI配准相结合。文中介绍了脑脊液动力学建模的基础知识，并讨论了植入式脑积水分流器功能评估的原则。多种测量形式的描述以及临床实例主要基于英国剑桥的一个多学科科学家和临床医生团队的内部经验。
