Document Detail


Cerebrospinal fluid outflow and intracranial pressure in hydrocephalic patients with external ventricular drainage.
MedLine Citation:
PMID:  19814755     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: The aim of this study was to monitor the 24 h cerebrospinal fluid (CSF) outflow and intracranial pressure (ICP) in hydrocephalic adult patients with external ventricular drainage (EVD).
PATIENTS AND METHODS: Twelve patients (5M/7F) aged 30-69 years suffering from acute hydrocephalus requiring EVD were admitted in the neuro-intensive care unit. The CSF collecting bag was continuously weighted using a high-precision scale, the filtered output of which was fed at 1 Hz to a computer and converted to flow (Q'ext(csf)). ICP was also recorded.
RESULTS: One patient was excluded because more than 80% of the Q'ext(csf) data were rejected by the system. The mean +/- SD Q'ext(csf) and ICP were respectively 7.5 +/- 3.4 ml/h (range 1.6-12.1 ml/h) and 12.4 +/- 2.7 mmHg. Two patterns of Q'ext(csf) were identified: a continuous profile and a discontinuous one with numerous bursts frequently associated with manoeuvres such as cough or chest physiotherapy. The short-term variations of Q'ext(csf) and ICP were usually unrelated.
CONCLUSION: The study stresses the important inter and intra-subject variability of Q'ext(csf) in patients with EVD. The mean Q'ext(csf) is lower than the reference production rate (21 ml/h), raising the question of persistent CSF absorption and/or depressed secretion. The independent changes of Q'ext(csf) and ICP on the short term is likely to be explained by the pressure-volume characteristics of the intracranial space.
Authors:
O Klein; B Demoulin; R T Jean Auque; G Audibert; C Sainte-Rose; J-C Marchal; F Marchal
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-10-08
Journal Detail:
Title:  Acta neurologica Scandinavica     Volume:  122     ISSN:  1600-0404     ISO Abbreviation:  Acta Neurol. Scand.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-07-15     Completed Date:  2010-11-22     Revised Date:  2011-06-29    
Medline Journal Info:
Nlm Unique ID:  0370336     Medline TA:  Acta Neurol Scand     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  140-7     Citation Subset:  IM    
Copyright Information:
(c) 2009 The Authors Journal compilation (c) 2009 Blackwell Munksgaard.
Affiliation:
Unit of Paediatric Neurosurgery and Department of Neurosurgery, Nancy University Hospital, 29 Avenue du Marchal de Lattre de Tassigny, Nancy Cedex, France. o.klein@chu-nancy.fr
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Aged
Cerebrospinal Fluid / physiology*
Cerebrospinal Fluid Pressure / physiology
Female
Humans
Hydrocephalus / physiopathology*,  surgery
Intracranial Pressure / physiology*
Male
Middle Aged
Observer Variation
Ventriculostomy*

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