Impact of Shunt Placement on CSF Dynamics
Background: CSF dynamics are disturbed in chronic hydrocephalus (NPH). We hypothesise that these alterations reflect a disturbance of intracranial compliance. The aim of our study is to investigate the variations in intracranial hydrodynamics in NPH after ventricular shunt surgery. Patients and meth...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-12-01
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| Series: | Biomedicines |
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| Online Access: | https://www.mdpi.com/2227-9059/12/1/20 |
| _version_ | 1797340065661190144 |
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| author | Cyrille Capel Kimi Owashi Serge Metanbou Johann Peltier Olivier Balédent |
| author_facet | Cyrille Capel Kimi Owashi Serge Metanbou Johann Peltier Olivier Balédent |
| author_sort | Cyrille Capel |
| collection | DOAJ |
| description | Background: CSF dynamics are disturbed in chronic hydrocephalus (NPH). We hypothesise that these alterations reflect a disturbance of intracranial compliance. The aim of our study is to investigate the variations in intracranial hydrodynamics in NPH after ventricular shunt surgery. Patients and method: We included 14 patients with definite NPH. All patients improved after ventriculoperitoneal shunting. The patients underwent an analysis of intracranial haemodynamics by phase-contrast MRI (pcMRI) preoperatively, at 6 months postoperatively, and at 1 year postoperatively. We analysed the dynamics of intraventricular CSF at the level of the aqueduct of Sylvius (SV<sub>AQU</sub>) and CSF at the level of the high cervical subarachnoid spaces (SV<sub>CERV</sub>). We calculated the ratio between SV<sub>AQU</sub> and SV<sub>CERV</sub>, called CSF<sub>RATIO</sub>, which reflects the participation of intraventricular pulsatility in overall intracranial CSF pulsatility. Results: SV<sub>AQU</sub> significantly (<i>p</i> = 0.003) decreased from 240 ± 114 μL/cc to 214 ± 157 μL/cc 6 months after shunt placement. Six months after shunt placement, SV<sub>CERV</sub> significantly (<i>p</i> = 0.007) decreased from 627 ± 229 μL/cc to 557 ± 234 μL/cc. Twelve months after shunt placement, SV<sub>CERV</sub> continued to significantly (<i>p</i> = 0.001) decrease to 496 ± 234 μL/cc. CSF<sub>RATIO</sub> was not changed by surgery. Conclusions: CSF dynamics are altered by shunt placement and might be a useful marker of the shunt’s effectiveness—especially if pressure values start to rise again. The detection of changes in CSF dynamics would require a reference postoperative pcMRI measurement for each patient. |
| first_indexed | 2024-03-08T09:57:33Z |
| format | Article |
| id | doaj.art-241fbb8f2e0644d189fe4f64ad0a3cdf |
| institution | Directory Open Access Journal |
| issn | 2227-9059 |
| language | English |
| last_indexed | 2024-03-08T09:57:33Z |
| publishDate | 2023-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomedicines |
| spelling | doaj.art-241fbb8f2e0644d189fe4f64ad0a3cdf2024-01-29T13:46:33ZengMDPI AGBiomedicines2227-90592023-12-011212010.3390/biomedicines12010020Impact of Shunt Placement on CSF DynamicsCyrille Capel0Kimi Owashi1Serge Metanbou2Johann Peltier3Olivier Balédent4Department of Neurosurgery, Hospital University Center of Amiens-Picardie, 80054 Amiens, FranceCHIMERE UR UPJV 7516, Jules Verne University, 80000 Amiens, FranceRadiology Department, Hospital University Center of Amiens-Picardie, 80054 Amiens, FranceDepartment of Neurosurgery, Hospital University Center of Amiens-Picardie, 80054 Amiens, FranceCHIMERE UR UPJV 7516, Jules Verne University, 80000 Amiens, FranceBackground: CSF dynamics are disturbed in chronic hydrocephalus (NPH). We hypothesise that these alterations reflect a disturbance of intracranial compliance. The aim of our study is to investigate the variations in intracranial hydrodynamics in NPH after ventricular shunt surgery. Patients and method: We included 14 patients with definite NPH. All patients improved after ventriculoperitoneal shunting. The patients underwent an analysis of intracranial haemodynamics by phase-contrast MRI (pcMRI) preoperatively, at 6 months postoperatively, and at 1 year postoperatively. We analysed the dynamics of intraventricular CSF at the level of the aqueduct of Sylvius (SV<sub>AQU</sub>) and CSF at the level of the high cervical subarachnoid spaces (SV<sub>CERV</sub>). We calculated the ratio between SV<sub>AQU</sub> and SV<sub>CERV</sub>, called CSF<sub>RATIO</sub>, which reflects the participation of intraventricular pulsatility in overall intracranial CSF pulsatility. Results: SV<sub>AQU</sub> significantly (<i>p</i> = 0.003) decreased from 240 ± 114 μL/cc to 214 ± 157 μL/cc 6 months after shunt placement. Six months after shunt placement, SV<sub>CERV</sub> significantly (<i>p</i> = 0.007) decreased from 627 ± 229 μL/cc to 557 ± 234 μL/cc. Twelve months after shunt placement, SV<sub>CERV</sub> continued to significantly (<i>p</i> = 0.001) decrease to 496 ± 234 μL/cc. CSF<sub>RATIO</sub> was not changed by surgery. Conclusions: CSF dynamics are altered by shunt placement and might be a useful marker of the shunt’s effectiveness—especially if pressure values start to rise again. The detection of changes in CSF dynamics would require a reference postoperative pcMRI measurement for each patient.https://www.mdpi.com/2227-9059/12/1/20hydrocephalushydrodynamiccerebrospinal fluidphase-contrast MRI |
| spellingShingle | Cyrille Capel Kimi Owashi Serge Metanbou Johann Peltier Olivier Balédent Impact of Shunt Placement on CSF Dynamics Biomedicines hydrocephalus hydrodynamic cerebrospinal fluid phase-contrast MRI |
| title | Impact of Shunt Placement on CSF Dynamics |
| title_full | Impact of Shunt Placement on CSF Dynamics |
| title_fullStr | Impact of Shunt Placement on CSF Dynamics |
| title_full_unstemmed | Impact of Shunt Placement on CSF Dynamics |
| title_short | Impact of Shunt Placement on CSF Dynamics |
| title_sort | impact of shunt placement on csf dynamics |
| topic | hydrocephalus hydrodynamic cerebrospinal fluid phase-contrast MRI |
| url | https://www.mdpi.com/2227-9059/12/1/20 |
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