PMID- 35644900
OWN - NLM
STAT- MEDLINE
DCOM- 20220628
LR  - 20230628
IS  - 0942-0940 (Electronic)
IS  - 0001-6268 (Print)
IS  - 0001-6268 (Linking)
VI  - 164
IP  - 7
DP  - 2022 Jul
TI  - The diagnostic value of the pulsatility curve to predict shunt responsiveness in 
      patients with idiopathic normal pressure hydrocephalus.
PG  - 1747-1754
LID - 10.1007/s00701-022-05233-7 [doi]
AB  - OBJECTIVE: The aim of this study was to investigate the diagnostic accuracy of 
      the pulsatility curve to predict shunt response in patients with idiopathic 
      normal pressure hydrocephalus (iNPH). METHODS: Lumbar cerebrospinal fluid 
      dynamics were derived from an automatic lumbar infusion test (LIT) protocol. All 
      patients were treated with ventriculoperitoneal shunting and re-examined 6 months 
      after shunting. Patient demographics and outcomes were gathered in a prospective, 
      electronic database that spanned from January 2012 to January 2020. A validated 
      iNPH scale was used to assess patients preoperatively and 6 months 
      postoperatively. The relationship of the relative pulse pressure coefficient 
      (RPPC), delta amplitude, successful lowering of amplitude, and the pressure-value 
      at a hypothetical amplitude of zero (P(0)), resistance to outflow (R(out)), and 
      outcome, were assessed using receiver operating characteristic (ROC) curves. 
      RESULTS: We included 38 patients. The RPPC, delta amplitude, successful lowering 
      of amplitude, and P(0) parameters did not predict shunt response. Mean P(0) was 
      0.5 (IQR 0.4-0.9) in improved patients and 0.4 (IQR 0-1.2) in non-improved 
      patients. The delta amplitude was 0.16 kPa (IQR 0.10-0.23) in improved patients 
      and 0.18 kPa (IQR 0.11-0.24) in non-improved patients. Furthermore, we found a 
      technical failure rate of pulsatility curve measurements of 32%. CONCLUSION: 
      Pulsatility curve results were not suitable in predicting shunt response in our 
      cohort. The diagnostic value of LIT in case of normal pressure hydrocephalus 
      should be subject to more rigorous research.
CI  - (c) 2022. The Author(s).
FAU - van Bilsen, M W T
AU  - van Bilsen MWT
AUID- ORCID: 0000-0002-8413-7922
AD  - Department of Neurosurgery, Radboud University Medical Center, Geert 
      Grooteplein-zuid 10, 6525GA, Nijmegen, The Netherlands. 
      martine.vanbilsen@radboudumc.nl.
FAU - van den Abbeele, L
AU  - van den Abbeele L
AD  - Department of Neurosurgery, Radboud University Medical Center, Geert 
      Grooteplein-zuid 10, 6525GA, Nijmegen, The Netherlands.
FAU - Volovici, V
AU  - Volovici V
AD  - Department of Neurosurgery, Erasmus Medical Center, Rotterdam, The Netherlands.
FAU - Boogaarts, H D
AU  - Boogaarts HD
AD  - Department of Neurosurgery, Radboud University Medical Center, Geert 
      Grooteplein-zuid 10, 6525GA, Nijmegen, The Netherlands.
FAU - Bartels, R H M A
AU  - Bartels RHMA
AD  - Department of Neurosurgery, Radboud University Medical Center, Geert 
      Grooteplein-zuid 10, 6525GA, Nijmegen, The Netherlands.
FAU - van Lindert, E J
AU  - van Lindert EJ
AD  - Department of Neurosurgery, Radboud University Medical Center, Geert 
      Grooteplein-zuid 10, 6525GA, Nijmegen, The Netherlands.
LA  - eng
PT  - Journal Article
DEP - 20220530
PL  - Austria
TA  - Acta Neurochir (Wien)
JT  - Acta neurochirurgica
JID - 0151000
SB  - IM
MH  - Cerebrospinal Fluid Shunts/methods
MH  - Humans
MH  - *Hydrocephalus, Normal Pressure/cerebrospinal fluid/diagnosis/surgery
MH  - Neurosurgical Procedures
MH  - Prospective Studies
MH  - Ventriculoperitoneal Shunt
PMC - PMC9233651
OTO - NOTNLM
OT  - Lumbar infusion testing
OT  - Normal pressure hydrocephalus
OT  - Pulsatility curve
EDAT- 2022/06/02 06:00
MHDA- 2022/06/29 06:00
PMCR- 2022/05/30
CRDT- 2022/06/01 10:57
PHST- 2021/03/29 00:00 [received]
PHST- 2022/04/28 00:00 [accepted]
PHST- 2022/06/02 06:00 [pubmed]
PHST- 2022/06/29 06:00 [medline]
PHST- 2022/06/01 10:57 [entrez]
PHST- 2022/05/30 00:00 [pmc-release]
AID - 10.1007/s00701-022-05233-7 [pii]
AID - 5233 [pii]
AID - 10.1007/s00701-022-05233-7 [doi]
PST - ppublish
SO  - Acta Neurochir (Wien). 2022 Jul;164(7):1747-1754. doi: 
      10.1007/s00701-022-05233-7. Epub 2022 May 30.