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Cerebrospinal fluid outflow and intracranial pressure in hydrocephalic patients with external ventricular drainage
Author(s) -
Klein O.,
Demoulin B.,
Jean Auque R. T.,
Audibert G.,
SainteRose C.,
Marchal J.C.,
Marchal F.
Publication year - 2010
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/j.1600-0404.2009.01281.x
Subject(s) - cerebrospinal fluid , intracranial pressure , hydrocephalus , medicine , anesthesia , intensive care , normal pressure hydrocephalus , surgery , intensive care medicine , disease , dementia
Klein O, Demoulin B, Jean Auque RT, Audibert G, Sainte‐Rose C, Marchal J‐C, Marchal F. Cerebrospinal fluid outflow and intracranial pressure in hydrocephalic patients with external ventricular drainage.
Acta Neurol Scand: DOI: 2010: 122: 140–147.
© 2009 The Authors Journal compilation © 2009 Blackwell Munksgaard. Background and purpose – The aim of this study was to monitor the 24 h cerebrospinal fluid (CSF) outflow and intracranial pressure (ICP) in hydrocephalic adult patients with external ventricular drainage (EVD). Patients and methods – Twelve patients (5M/7F) aged 30–69 years suffering from acute hydrocephalus requiring EVD were admitted in the neuro‐intensive care unit. The CSF collecting bag was continuously weighted using a high‐precision scale, the filtered output of which was fed at 1 Hz to a computer and converted to flow (Q′ext csf ). ICP was also recorded. Results – One patient was excluded because more than 80% of the Q′ext csf data were rejected by the system. The mean ± SD Q′ext csf and ICP were respectively 7.5 ± 3.4 ml/h (range 1.6–12.1 ml/h) and 12.4 ± 2.7 mmHg. Two patterns of Q′ext csf were identified: a continuous profile and a discontinuous one with numerous bursts frequently associated with manoeuvres such as cough or chest physiotherapy. The short‐term variations of Q′ext csf and ICP were usually unrelated. Conclusion – The study stresses the important inter and intra‐subject variability of Q′ext csf in patients with EVD. The mean Q′ext csf is lower than the reference production rate (21 ml/h), raising the question of persistent CSF absorption and/or depressed secretion. The independent changes of Q′ext csf and ICP on the short term is likely to be explained by the pressure–volume characteristics of the intracranial space.