Czosnyka Zofia H, Czosnyka Marek, Smielewski Piotr, Lalou Afroditi D, Nabbanja Eva, Garnett Matthew, Barszcz Slawomir, Schmidt Eric A, Momjian Shahan, Kasprowicz Magda, Petrella Gianpaolo, Owler Brian, Keong Nicole C, Hutchinson Peter J, Pickard John D
Division of Neurosurgery, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK.
Neurosurgery, Medical Academy Pediatric Hospital, ul Zwirki I Wigury, Warsaw, Poland.
Acta Neurochir Suppl. 2021;131:311-313. doi: 10.1007/978-3-030-59436-7_58.
Normal pressure hydrocephalus is more complex than a simple disturbance of the cerebrospinal fluid (CSF) circulation. Nevertheless, an assessment of CSF dynamics is key to making decisions about shunt insertion, shunt malfunction, and for further management if a patient fails to improve. We summarize our 25 years of single center experience in CSF dynamics assessment using pressure measurement and analysis. 4473 computerized infusion tests have been performed. We have shown that CSF infusion studies are safe, with incidence of infection at less than 1%. Raised resistance to CSF outflow positively correlates (p < 0.014) with improvement after shunting and is associated with disturbance of cerebral blood flow and its autoregulation (p < 0.02). CSF infusion studies are valuable in assessing possible shunt malfunction in vivo and for avoiding unnecessary revisions. Infusion tests are safe and provide useful information for clinical decision-making for the management of patients suffering from hydrocephalus.
正常压力脑积水比单纯的脑脊液（CSF）循环紊乱更为复杂。然而，评估脑脊液动力学是决定是否进行分流术、分流器故障以及患者病情无改善时进一步治疗的关键。我们总结了25年来在单中心使用压力测量和分析评估脑脊液动力学的经验。已进行了4473次计算机化输液试验。我们已经表明，脑脊液输液研究是安全的，感染发生率低于1%。脑脊液流出阻力增加与分流术后改善呈正相关（p<0.014），并与脑血流及其自动调节紊乱有关（p<0.02）。脑脊液输液研究对于评估体内可能的分流器故障和避免不必要的翻修很有价值。输液试验是安全的，并为脑积水患者的临床决策管理提供有用信息。
