Analysis of CSF dynamics by computerized pressure-elastance resorption test in hydrocephalic children. Indications for surgery.

Since 1982, 23 hydrocephalic children have been studied for compensatory mechanisms of the cerebrospinal fluid system. The authors describe the method and results of a computerized pressure-elastance resorption test (CPERT), a spinal steady-state infusion test, in hydrocephalic children. Computerized analysis of the P/V and AMP/P curve provides valuable data that precisely describe the degree of disturbances of CSF dynamics. The following parameters were quantitatively determined: out-flow resistance, opening pressure, elastance, elasticity, reference pressure and optimum (break-point) pressure. It is concluded that the described test allows the differential diagnosis of chronic hydrocephalus in children. The value of optimum pressure (analysis of AMP-P relation) gives precise indications for surgery and the selection of a valve system with adequate opening pressure. In some cases, the CPERT test can be used instead of continuous ICP monitoring.