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PET and CBF Studies of Chronic Hydrocephalus: A Contribution to Surgical Indication and Prognosis
Author(s) -
Klinge Petra,
Fischer Jens,
Brinker Thomas,
Heissler Hans E.,
Burchert Wolfgang,
Berding Georg,
Knapp Wolfram H.,
Samii Madjid
Publication year - 1998
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/jon199884205
Subject(s) - medicine , cerebral blood flow , shunting , hydrocephalus , cerebrospinal fluid , normal pressure hydrocephalus , shunt (medical) , positron emission tomography , intracranial pressure , anesthesia , surgery , radiology , disease , dementia
The authors investigate whether measurement of cerebral blood flow (CBF) in chronic hydrocephalus is a reliable indicator in selecting patients to undergo ventriculoperitoneal shunting. Global and regional CBF is quantified (Kety‐Schmidt one‐compartment model) by positron emission tomography in 21 patients. CBF is determined following inJection of 15 0‐H2O at three time points 1 week before, 7 days after, and 7 months after shunting. The neurological status of these patients is classified, and cerebrospinal fluid (CSF) dynamics (continuous intracranial pressure [ICP] monitoring and CSF infusion tests) were assessed prior to surgery. Preoperative global CBF values correlate well with clinical outcome. Patients with a significantly lower global CBF value show clinical improvement after 7 months, whereas patients with higher CBF values do not (mean, 33 vs. 45 ml/1 00 ml per minute; p < 0 05). In contrast to conventional methods, including long‐term ICP measurement and CSF infusion tests, preoperative global CBF values are discriminating in terms of clinical outcome. Thus, measurement of CBF may be helpful in evaluating the ultimate utility of shunt therapy in chronic hydrocephalus.