Implementation of a new CSF dynamic device: a multicenter feasibility study in 562 patients

• Objectives - The cerebrospinal fluid (CSF) infusion test is frequently used when selecting hydrocephalus patients for shunt surgery. Very little has been reported regarding adverse events. We present a prospective feasibility study. Methods -Standardized devices for measuring CSF dynamics were built and 562 patients investigated: Needles were placed by lumbar puncture (LP). An automatic CSF infusion protocol was performed. Course of events during the investigation as well as adverse events were registered. Results Preoperative evaluation of normal-pressure hydrocephalus was the most common indication (63%), followed by evaluation of shunt function (23%) and intracranial pressure recordings (14%). The LP was successfully performed in all but nine cases with 24 patients (4.3%) reporting major discomfort. Ringer infusion was performed in 474 investigations, and a valid measurement of the outflow resistance was received in 439 (93%). During the infusion phase, 17 (4%) patients reported severe headache. Infusion volume was significantly higher in patients having subjective symptoms during the infusion phase compared with those without adverse events. During 269 preoperative CSF tap tests, six (2%) patients had severe headache. Postinvestigational headache was reported by 83 (15%) patients at the 24-h follow-up. No serious adverse events were observed. Conclusion Infusion testing was safe and without serious adverse events with a high rate of successful procedures. The investigation was associated with expected mild to moderate discomfort.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Medicinska och farmaceutiska grundvetenskaper -- Neurovetenskaper (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Basic Medicine -- Neurosciences (hsv//eng)

Keyword

hydrocephalus

normal pressure

intracranial pressure

cerebrospinal fluid

physiology

cerebrospinal fluid dynamics

cerebrospinal fluid pressure

cerebrospinal fluid outflow resistance

infusion test

predictive test

cerebrospinal fluid shunts

MEDICINE

MEDICIN

Cerebrospinal fluid dynamics

Cerebrospinal fluid outflow resistance

Cerebrospinal fluid pressure

Cerebrospinal fluid shunts

Cerebrospinal fluid/physiology

Hydrocephalus

Infusion test

Intracranial pressure

Normal pressure

Predictive test

Publication and Content Type

ref (subject category)

art (subject category)