Our policy in diagnosis and treatment of hydrocephalus

The authors present the policy they have worked out for hydrocephalus patients with special reference to the pressure measurement and test methods and to rCBF, SPECT and transcranial Doppler sonography (TDC) studies. For diagnosis, the protocol proposed by Gjerris and Borgesen was followed in 75 cas...

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Bibliographic Details
Published in:Child's nervous system 1995-02, Vol.11 (2), p.102-106
Main Authors: KOPNICZKY, Z, BARZO, P, PAVICS, L, DOCZI, T, BODOSI, M, CSERNAY, L
Format: Article
Language:English
Subjects:
Biological and medical sciences
Blood Flow Velocity - physiology
Brain - blood supply
Cerebrospinal Fluid Pressure - physiology
Cerebrospinal Fluid Shunts
Cerebrospinal fluid. Meninges. Spinal cord
Child
Child, Preschool
Diagnostic Imaging
Follow-Up Studies
Hemodynamics - physiology
Homeostasis - physiology
Humans
Hydrocephalus - diagnosis
Hydrocephalus - etiology
Hydrocephalus - physiopathology
Hydrocephalus - surgery
Infant
Medical sciences
Nervous system (semeiology, syndromes)
Neurologic Examination
Neurology
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Summary:The authors present the policy they have worked out for hydrocephalus patients with special reference to the pressure measurement and test methods and to rCBF, SPECT and transcranial Doppler sonography (TDC) studies. For diagnosis, the protocol proposed by Gjerris and Borgesen was followed in 75 cases: besides other methods (CT, radionuclide cisternography, MRI) the intracranial pressure waves routinely recorded and analyzed by means of ventricular catheters for 24 h. The patients were roughly divided into groups in terms of diagnosis, baseline pressure, compliance, results of infusion tests and of surgery. In 13 patients the investigations were supplemented by rCBF SPECT and in 42 patients by TCD studies before and after CSF shunting or withdrawal to analyze the acute effects on cerebral circulation. Clinical follow-up shows that need for shunting was indicated fairly well by the common results of baseline ICP, compliance and infusion loading. The rCBF SPECT studies revealed a significant increase of the cerebral perfusion at the basal ganglia after shunting while, on the basis of CBF velocity changes three types of vasoregulatory response could be defined with TCD. In our hands, monitoring of the pressure and craniospinal capacity has proved to be a valuable aid in decisions on surgery; however, for a more precise (and beneficial) appreciation of whether surgery is indicated the vasoregulatory responses should also be taken into account in future.
ISSN:0256-7040
1433-0350
DOI:10.1007/BF00303814