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Implementation of a new CSF dynamic device: a multicenter feasibility study in 562 patients
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurosurgery.
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2012 (English)In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 125, no 3, 199-205 p.Article in journal (Refereed) Published
Abstract [en]

Objectives: The cerebrospinal fluid (CSF) infusion test is frequently used when selecting hydrocephalus patients for shunt surgery. Very little has been reported regarding adverse events. We present a prospective feasibility study.

Methods: Standardized devices for measuring CSF dynamics were built and 562 patients investigated: Needles were placed by lumbar puncture (LP). An automatic CSF infusion protocol was performed. Course of events during the investigation as well as adverse events were registered.

Results: Preoperative evaluation of normal-pressure hydrocephalus was the most common indication (63%), followed by evaluation of shunt function (23%) and intracranial pressure recordings (14%). The LP was successfully performed in all but nine cases with 24 patients (4.3%) reporting major discomfort. Ringer infusion was performed in 474 investigations, and a valid measurement of the outflow resistance was received in 439 (93%). During the infusion phase, 17 (4%) patients reported severe headache. Infusion volume was significantly higher in patients having subjective symptoms during the infusion phase compared with those without adverse events. During 269 preoperative CSF tap tests, six (2%) patients had severe headache. Postinvestigational headache was reported by 83 (15%) patients at the 24-h follow-up. No serious adverse events were observed.

Conclusion: Infusion testing was safe and without serious adverse events with a high rate of successful procedures. The investigation was associated with expected mild to moderate discomfort.

Place, publisher, year, edition, pages
2012. Vol. 125, no 3, 199-205 p.
Keyword [en]
hydrocephalus, normal pressure, intracranial pressure, cerebrospinal fluid, physiology, cerebrospinal fluid dynamics, cerebrospinal fluid pressure, cerebrospinal fluid outflow resistance, infusion test, predictive test, cerebrospinal fluid shunts
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-169942DOI: 10.1111/j.1600-0404.2011.01533.xISI: 000299997800010OAI: oai:DiVA.org:uu-169942DiVA: diva2:508452
Available from: 2012-03-08 Created: 2012-03-07 Last updated: 2012-03-08Bibliographically approved

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