Pressure compensation in shunt-dependent hydrocephalus with CSF shunt malfunction

This study is a retrospective analysis of intracranial pressure (ICP) and cerebral perfusion pressure (CPP) data from 56 children with active hydrocephalus and cerebrospinal fluid (CSF) shunt malfunction. The pressures were measured from a separately sited CSF access device placed in the frontal hor...

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Bibliographic Details
Published in:Child's nervous system 2001-01, Vol.17 (1-2), p.52-57
Main Authors: GILKES, C. E, STEERS, A. J. W, MINNS, R. A
Format: Article
Language:English
Subjects:
Adolescent
Biological and medical sciences
Brain - pathology
Brain - physiopathology
Cerebrospinal Fluid Shunts - instrumentation
Cerebrospinal fluid. Meninges. Spinal cord
Child, Preschool
Equipment Failure
Female
Humans
Hydrocephalus - diagnosis
Hydrocephalus - physiopathology
Hydrocephalus - surgery
Infant
Intracranial Pressure - physiology
Magnetic Resonance Imaging
Male
Medical sciences
Nervous system (semeiology, syndromes)
Neurology
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Summary:This study is a retrospective analysis of intracranial pressure (ICP) and cerebral perfusion pressure (CPP) data from 56 children with active hydrocephalus and cerebrospinal fluid (CSF) shunt malfunction. The pressures were measured from a separately sited CSF access device placed in the frontal horn of the lateral ventricle. Of the patients, 79% had an elevated ICP (mean 20+/-12 mmHg). A subgroup of patients demonstrated ten different forms of CSF-filled swelling. This group had significantly lower ICP recordings (P=0.000075) with a mean ICP of 8.5 mmHg compared with the remainder (22.9 mmHg). This pressure 'compensation' was because of additional nonphysiological accommodation of CSF volume. Overall the CPP was normal in 35% of cases despite normal ICP occurring in only 11% of cases. The CPPs were not significantly different in those with and without compensation. Measurement of ICP may not always be a reliable indicator of shunt malfunction in shunt-dependent children who present with compensatory CSF-filled spaces.
ISSN:0256-7040
1433-0350
DOI:10.1007/s003810000355