Eva Nabbanja1, Marek Czosnyka2, Nicole C Keong3, Matthew Garnett1, John D Pickard1, Despina Afroditi Lalou2, Zofia Czosnyka4,5. 1. Division of Neurosurgery, Cambridge University Hospital, Cambridge, UK. 2. Brain Physics Lab, Division of Neurosurgery, Cambridge University Hospital, Cambridge, UK. 3. Department of Neurosurgery, National Neuroscience Institute and Duke-NUS Graduate Medical School, Singapore, Singapore. 4. Division of Neurosurgery, Cambridge University Hospital, Cambridge, UK. zc200@medschl.cam.ac.uk. 5. Brain Physics Lab, Division of Neurosurgery, Cambridge University Hospital, Cambridge, UK. zc200@medschl.cam.ac.uk.
Abstract
OBJECTIVE: The term "hydrocephalus" encompasses a range of disorders characterised by clinical symptoms, abnormal brain imaging and derangement of cerebrospinal fluid (CSF) dynamics. The ability to elucidate which patients would benefit from CSF diversion (a shunt or third ventriculostomy) is often unclear. Similar difficulties are encountered in shunted patients to predict the scope for improvement by shunt re-adjustment or revision. MATERIALS AND METHODS: We compared retrospective pre-shunting infusion test results performed in 310 adult patients diagnosed with normal pressure hydrocephalus (NPH) and their improvement after shunting. RESULTS: Resistance to CSF outflow correlated significantly with improvement (p < 0.05). Other markers known from the literature, such as amplitude in CSF pulse pressure, the slope of the amplitude-pressure regression line, or elasticity did not show any correlation with outcome. CONCLUSION: Outcome following shunting in adult NPH is associated with resistance to CSF outflow; however, the latter cannot be taken as an absolute predictor of shunt response.
OBJECTIVE: The term "hydrocephalus" encompasses a range of disorders characterised by clinical symptoms, abnormal brain imaging and derangement of cerebrospinal fluid (CSF) dynamics. The ability to elucidate which patients would benefit from CSF diversion (a shunt or third ventriculostomy) is often unclear. Similar difficulties are encountered in shunted patients to predict the scope for improvement by shunt re-adjustment or revision. MATERIALS AND METHODS: We compared retrospective pre-shunting infusion test results performed in 310 adult patients diagnosed with normal pressure hydrocephalus (NPH) and their improvement after shunting. RESULTS: Resistance to CSF outflow correlated significantly with improvement (p < 0.05). Other markers known from the literature, such as amplitude in CSF pulse pressure, the slope of the amplitude-pressure regression line, or elasticity did not show any correlation with outcome. CONCLUSION: Outcome following shunting in adult NPH is associated with resistance to CSF outflow; however, the latter cannot be taken as an absolute predictor of shunt response.
Authors: Afroditi-Despina Lalou; James S McTaggart; Zofia H Czosnyka; Matthew R Garnett; Deepa Krishnakumar; Marek Czosnyka Journal: Childs Nerv Syst Date: 2019-07-19 Impact factor: 1.475
Authors: Nicole C Keong; Christine Lock; Shereen Soon; Aditya Tri Hernowo; Zofia Czosnyka; Marek Czosnyka; John D Pickard; Vairavan Narayanan Journal: Front Neurol Date: 2022-07-06 Impact factor: 4.086
Authors: M W T van Bilsen; L van den Abbeele; V Volovici; H D Boogaarts; R H M A Bartels; E J van Lindert Journal: Acta Neurochir (Wien) Date: 2022-05-30 Impact factor: 2.816
Authors: Eng Tah Goh; Christine Lock; Audrey Jia Luan Tan; Bee Ling Tan; Sai Liang; Robin Pillay; Sumeet Kumar; Azlina Ahmad-Annuar; Vairavan Narayanan; Janell Kwok; Yi Jayne Tan; Adeline Sl Ng; Eng King Tan; Zofia Czosnyka; Marek Czosnyka; John D Pickard; Nicole C Keong Journal: Front Neurol Date: 2022-07-12 Impact factor: 4.086
Authors: Afroditi D Lalou; Virginia Levrini; Marek Czosnyka; Laurent Gergelé; Matthew Garnett; Angelos Kolias; Peter J Hutchinson; Zofia Czosnyka Journal: Fluids Barriers CNS Date: 2020-03-30