PMID- 31912355
OWN - NLM
STAT- MEDLINE
DCOM- 20201109
LR  - 20201109
IS  - 0942-0940 (Electronic)
IS  - 0001-6268 (Linking)
VI  - 162
IP  - 5
DP  - 2020 May
TI  - Timing of intraventricular infusion test for diagnosing idiopathic normal 
      pressure hydrocephalus.
PG  - 1011-1017
LID - 10.1007/s00701-019-04168-w [doi]
AB  - BACKGROUND: Infusion tests, which measure resistance to outflow (R(out)), are 
      used in selecting patients suspected for idiopathic normal pressure hydrocephalus 
      (iNPH) for shunt surgery. Infusion tests can be performed through an external 
      ventricular drain (EVD). A 24-hour time gap from EVD insertion to an infusion 
      test is a routine practice at our department due to concerns that the surgical 
      procedure might influence the test results in the immediate postoperative period. 
      The objective of the study was to investigate if timing of an intraventricular 
      infusion test influences the results of the test in patients suspected for iNPH. 
      METHODS: Ten patients scheduled for an intraventricular infusion test were 
      included. Measurements of baseline intracranial pressure (ICP) and plateau ICP 
      were obtained during constant rate intraventricular infusion test performed at 
      two time points (1 and 24 h after EVD insertion) and R(out) was calculated from 
      these measures and compared within patients. RESULTS: Eight patients completed 
      both infusion tests. In one of the 18 infusion tests performed, it was not 
      possible to define an ICP plateau and this infusion test was excluded, leaving 7 
      paired infusion tests. Median R(out) was 12.9 mmHg/ml/min (range 7.0-22.0) 1 h 
      after EVD insertion and 11.3 mmHg/ml/min (range 7.8-18.1) after 24 h. Overall, 
      there were no statistically significant differences in R(out) (P = 0.83), 
      baseline ICP (P = 0.70), or plateau ICP (P = 0.81) between the recordings 
      performed 1 h and 24 h after EVD insertion. For two of the seven patients with 
      paired infusion tests, there was poor agreement between R(out) values at 1 and 24 
      h. CONCLUSION: Overall, R(out) estimates do not change significantly between 1 
      and 24 h after EVD insertion. We therefore propose that infusion tests can be 
      performed shortly after surgery to reduce the period of indwelling EVD and 
      duration of hospitalization.
FAU - Andreasen, Trine Hjorslev
AU  - Andreasen TH
AUID- ORCID: 0000-0001-5707-8712
AD  - Department of Neurosurgery, Copenhagen University Hospital Rigshospitalet, 
      Blegdamsvej 9, 2100, Copenhagen, Denmark. trinehjorslev@hotmail.com.
FAU - Lilja-Cyron, Alexander
AU  - Lilja-Cyron A
AD  - Department of Neurosurgery, Copenhagen University Hospital Rigshospitalet, 
      Blegdamsvej 9, 2100, Copenhagen, Denmark.
FAU - Holst, Anders Vedel
AU  - Holst AV
AD  - Department of Neurosurgery, Copenhagen University Hospital Rigshospitalet, 
      Blegdamsvej 9, 2100, Copenhagen, Denmark.
FAU - Christoffersen, Dorthe
AU  - Christoffersen D
AD  - Department of Neurosurgery, Copenhagen University Hospital Rigshospitalet, 
      Blegdamsvej 9, 2100, Copenhagen, Denmark.
FAU - Johnsen, Sara Duus
AU  - Johnsen SD
AD  - Department of Neurosurgery, Copenhagen University Hospital Rigshospitalet, 
      Blegdamsvej 9, 2100, Copenhagen, Denmark.
FAU - Juhler, Marianne
AU  - Juhler M
AD  - Department of Neurosurgery, Copenhagen University Hospital Rigshospitalet, 
      Blegdamsvej 9, 2100, Copenhagen, Denmark.
LA  - eng
PT  - Journal Article
DEP - 20200107
PL  - Austria
TA  - Acta Neurochir (Wien)
JT  - Acta neurochirurgica
JID - 0151000
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Humans
MH  - Hydrocephalus, Normal Pressure/*diagnosis/physiopathology
MH  - Infusions, Intraventricular
MH  - Intracranial Pressure/*physiology
MH  - Male
MH  - Middle Aged
OTO - NOTNLM
OT  - CSF outflow
OT  - Infusion test
OT  - Intracranial pressure monitoring
OT  - Normal pressure hydrocephalus
EDAT- 2020/01/09 06:00
MHDA- 2020/11/11 06:00
CRDT- 2020/01/09 06:00
PHST- 2019/08/25 00:00 [received]
PHST- 2019/12/05 00:00 [accepted]
PHST- 2020/01/09 06:00 [pubmed]
PHST- 2020/11/11 06:00 [medline]
PHST- 2020/01/09 06:00 [entrez]
AID - 10.1007/s00701-019-04168-w [pii]
AID - 10.1007/s00701-019-04168-w [doi]
PST - ppublish
SO  - Acta Neurochir (Wien). 2020 May;162(5):1011-1017. doi: 
      10.1007/s00701-019-04168-w. Epub 2020 Jan 7.