Comparison of ventricular drain location and infusion test in hydrocephalus
Acta Neurologica Scandinavica
MetadataShow full item record
Sinha, R., Morgan, J., Wawrzynski, J., Czosnyka, Z., Kasprowicz, M., Czosnyka, M., Garnett, M., et al. (2017). Comparison of ventricular drain location and infusion test in hydrocephalus. Acta Neurologica Scandinavica, 135 (3), 291-301. https://doi.org/10.1111/ane.12594
Objectives: Suspected cerebrospinal fluid shunt (CSF) dysfunction in hydrocephalic patients poses a diagnostic uncertainty. The clinical picture can be nonspecific and CT imaging alone is not always pathognomic. Infusion tests are an increasingly used investigation for real-time hydrodynamic assessment of shunt patency. We report correlation between infusion test results with quality of ventricular drain placement on CT image in large retrospective group of hydrocephalic patients. Materials & methods: 306 infusion test results performed in 200 patients were correlated with 306 corresponding CT head scans. Nominal logistic regression was used to correlate shunt catheter position on imaging to patency of ventricular drain as determined by infusion tests. Results: Infusion test results of shunt patency are statistically congruent with the analysis of shunt catheter position on CT head scans. Catheter tips completely surrounded by either parenchyma or CSF on CT imaging, are strongly associated with evidence of occlusion or patency from infusion tests, respectively (χ²=51.68, p<0.0001, n=306 and χ²=31.04, p <0.0001, n=306). Conclusions: The most important anatomical factor for shunt patency is the catheter tip being completely surrounded by CSF. Infusion tests provide functional and reliable assessment of shunt patency in vivo and is strongly correlated with the position of the ventricular catheter on CT imaging.
hydrocephalus, infusion tests, ventriculoperitoneal shunts, Adolescent, Adult, Aged, Aged, 80 and over, Cerebrospinal Fluid Shunts, Child, Child, Preschool, Female, Humans, Hydrocephalus, Infant, Male, Middle Aged, Retrospective Studies, Spinal Puncture, Tomography, X-Ray Computed, Young Adult
External DOI: https://doi.org/10.1111/ane.12594
This record's URL: https://www.repository.cam.ac.uk/handle/1810/254474