Document Detail


Cerebrovascular physiology in perinates with congenital hydrocephalus.
MedLine Citation:
PMID:  20082196     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: This study investigated changes in regional cerebral blood flow (rCBF), autoregulation (AR), and mean CO(2) reactivity (CO(2)r) in nine neonates, who underwent cerebrospinal fluid (CSF) diversion for congenital hydrocephalus. METHODS: During shunt insertion, a thermal diffusion probe inserted adjacent to the ventricular catheter in the right parietal region recorded rCBF. Changes in rCBF, mean arterial pressure, intracranial pressure (ICP), and expired CO(2) tension were recorded before and after removing CSF. RESULTS: Mean baseline rCBF for the entire group was 19.5 mL/100 g/min (range 8.4-44.8), with a mean ICP of 9.9 mmHg (range 4-20). Following CSF removal, the rCBF increased significantly in two patients. Three patients demonstrated AR throughout their studies; one infant showed AR after CSF removal. One infant without AR during shunt insertion showed an increase in rCBF and AR during a revision 5 months later. Baseline CO(2)r varied considerably but was greater than two in two patients and increased in three other children after CSF removal. Mean follow-up was 23.6 months. One child, with severe developmental delay, died. Death or severe delay was associated with the absence of AR and a negative CO(2)r in three children. Normal or mild developmental delay was associated with AR and a neutral or positive CO(2)r in five patients. CONCLUSIONS: Baseline levels of rCBF were not associated with developmental prognosis. AR and a positive CO(2)r were necessary but insufficient factors for normal development. The absence of AR and a negative CO(2)r were associated with poor prognosis.
Authors:
William C Hanigan; Donna Bogner
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Publication Detail:
Type:  Journal Article     Date:  2010-01-15
Journal Detail:
Title:  Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery     Volume:  26     ISSN:  1433-0350     ISO Abbreviation:  Childs Nerv Syst     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-12     Completed Date:  2010-08-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8503227     Medline TA:  Childs Nerv Syst     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  775-80     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA. WHanigan@umsmed.edu
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MeSH Terms
Descriptor/Qualifier:
Blood Pressure*
Carbon Dioxide / metabolism*
Cerebrospinal Fluid Shunts
Cerebrovascular Circulation*
Developmental Disabilities / diagnosis,  physiopathology,  surgery
Female
Follow-Up Studies
Humans
Hydrocephalus / diagnosis,  physiopathology*,  surgery
Infant, Newborn
Intracranial Pressure*
Male
Parietal Lobe / blood supply,  physiopathology,  radiography
Prognosis
Time Factors
Tomography, X-Ray Computed
Treatment Outcome
Chemical
Reg. No./Substance:
124-38-9/Carbon Dioxide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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