Is ventriculomegaly in idiopathic normal pressure hydrocephalus associated with a transmantle gradient in pulsatile intracranial pressure?
- PMID: 20130957
- DOI: 10.1007/s00701-010-0605-x
Is ventriculomegaly in idiopathic normal pressure hydrocephalus associated with a transmantle gradient in pulsatile intracranial pressure?
Abstract
Purpose: In patients with idiopathic normal pressure hydrocephalus (iNPH) and ventriculomegaly, examine whether there is a gradient in pulsatile intracranial pressure (ICP) from within the cerebrospinal fluid (CSF) of cerebral ventricles (ICP(IV)) to the subdural (ICP(SD)) compartment. We hypothesized that pulsatile ICP is higher within the ventricular CSF.
Methods: The material includes 10 consecutive iNPH patients undergoing diagnostic ICP monitoring as part of pre-operative work-up. Eight patients had simultaneous ICP(IV) and ICP(SD) signals, and two patients had simultaneous signals from the lateral ventricle (ICP(IV)) and the brain parenchyma (ICP(PAR)). Intracranial pulsatility was characterized by the wave amplitude, rise time, and rise time coefficient; static ICP was characterized by mean ICP.
Results: None of the patients demonstrated gradients in pulsatile ICP, that is, we found no evidence of higher pulsatile ICP within the CSF of the cerebral ventricles (ICP(IV)), as compared to either the subdural (ICP(SD)) compartment or within the brain parenchyma (ICP(PAR)). During ventricular infusion testing in one patient, the ventricular ICP (ICP(IV)) was artificially increased, but this increase in ICP(IV) produced no gradient in pulsatile ICP from the ventricular CSF (ICP(IV)) to the parenchyma (ICP(PAR)).
Conclusions: In this cohort of iNPH patients, we found no evidence of transmantle gradient in pulsatile ICP. The data gave no support to the hypothesis that pulsatile ICP is higher within the CSF of the cerebral ventricles (ICP(IV)) than within the subdural (ICP(SD)) compartment or the brain parenchyma (ICP(PAR)) in iNPH patients.
Similar articles
-
Diagnostic intracranial pressure monitoring and surgical management in idiopathic normal pressure hydrocephalus: a 6-year review of 214 patients.Neurosurgery. 2010 Jan;66(1):80-91. doi: 10.1227/01.NEU.0000363408.69856.B8. Neurosurgery. 2010. PMID: 20023540 Review.
-
Intracranial pulse pressure amplitude levels determined during preoperative assessment of subjects with possible idiopathic normal pressure hydrocephalus.Acta Neurochir (Wien). 2006 Nov;148(11):1151-6; discussion 1156. doi: 10.1007/s00701-006-0896-0. Epub 2006 Oct 16. Acta Neurochir (Wien). 2006. PMID: 17039303
-
Changes in intracranial pulse pressure amplitudes after shunt implantation and adjustment of shunt valve opening pressure in normal pressure hydrocephalus.Acta Neurochir (Wien). 2008 Nov;150(11):1141-7; discussion 1147. doi: 10.1007/s00701-008-0138-8. Epub 2008 Oct 21. Acta Neurochir (Wien). 2008. PMID: 18936877
-
Demonstration of uneven distribution of intracranial pulsatility in hydrocephalus patients.J Neurosurg. 2008 Nov;109(5):912-7. doi: 10.3171/JNS/2008/109/11/0912. J Neurosurg. 2008. PMID: 18976084
-
Intracranial pressure and ventricular expansion in hydrocephalus: have we been asking the wrong question?J Neurol Sci. 2008 Jun 15;269(1-2):1-11. doi: 10.1016/j.jns.2007.12.022. Epub 2008 Jan 30. J Neurol Sci. 2008. PMID: 18234229 Review.
Cited by
-
Intracranial Pressure Monitoring: Invasive versus Non-Invasive Methods-A Review.Crit Care Res Pract. 2012;2012:950393. doi: 10.1155/2012/950393. Epub 2012 Jun 8. Crit Care Res Pract. 2012. PMID: 22720148 Free PMC article.
-
Measuring intracranial pressure by invasive, less invasive or non-invasive means: limitations and avenues for improvement.Fluids Barriers CNS. 2020 May 6;17(1):34. doi: 10.1186/s12987-020-00195-3. Fluids Barriers CNS. 2020. PMID: 32375853 Free PMC article. Review.
-
Differences in the Calculated Transvenous Pressure Drop between Chronic Hydrocephalus and Idiopathic Intracranial Hypertension.AJNR Am J Neuroradiol. 2019 Jan;40(1):68-73. doi: 10.3174/ajnr.A5883. Epub 2018 Nov 22. AJNR Am J Neuroradiol. 2019. PMID: 30467220 Free PMC article.
-
The pulsating brain: A review of experimental and clinical studies of intracranial pulsatility.Fluids Barriers CNS. 2011 Jan 18;8(1):5. doi: 10.1186/2045-8118-8-5. Fluids Barriers CNS. 2011. PMID: 21349153 Free PMC article.
-
Glymphatic MRI in idiopathic normal pressure hydrocephalus.Brain. 2017 Oct 1;140(10):2691-2705. doi: 10.1093/brain/awx191. Brain. 2017. PMID: 28969373 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources