Cerebral blood flow and autoregulation in normal pressure hydrocephalus

Neurosurgery
A TanakaM Tomonaga

Abstract

We tried to identify indications for cerebrospinal fluid shunting in patients with normal pressure hydrocephalus. We studied the cerebral blood flow (CBF) and vascular response to acetazolamide in the white matter, cortex, and thalamus of 21 patients with normal pressure hydrocephalus, comparing patients who improved clinically after shunting with those who did not. We used xenon-enhanced computed tomography for the CBF measurements. Preoperatively, both groups had globally reduced CBF, but the reduction was more pronounced in the unimproved patients. The vascular response was impaired only in the white matter of the patients who improved later. After shunting, restoration of CBF, more marked in the white matter, and recovery of vascular response in the white matter paralleled clinical improvement and a reduction in ventricular dilation and periventricular lucency on computed tomographic scans in nine patients. The CBF reduction, however, deteriorated in the 12 patients who did not improve clinically. We conclude that the underlying disease in the improved patients was ischemia, with a loss of autoregulatory capacity in the periventricular white matter caused by cerebrospinal fluid diffusion. Those who did not improve had irrev...Continue Reading

References

Sep 1, 1975·Archives of Neurology·V C HachinskiL Symon
Jan 1, 1990·Stroke; a Journal of Cerebral Circulation·T V BogsrudR Nyberg-Hansen
Dec 1, 1987·Journal of Neurology, Neurosurgery, and Psychiatry·N R Graff-RadfordP T Kirchner
Oct 1, 1987·Journal of Neurosurgery·H G SullivanD E McDonnell
Nov 1, 1987·Stroke; a Journal of Cerebral Circulation·H L MamoJ A Seylaz
Feb 1, 1985·Surgical Neurology·J S MeyerR G Grossman
Apr 1, 1985·Journal of Neurosurgery·J S MeyerJ E Rose
Nov 1, 1984·The Journal of Clinical Investigation·S VorstrupO B Paulson
Jul 1, 1980·Archives of Neurology·F YamaguchiT Shaw
Jan 1, 1993·Acta Neuropathologica·M R Del Bigio

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Citations

Dec 16, 1998·Neurosurgery·R R Pindzola, H Yonas
Mar 21, 2002·Acta Neurologica Scandinavica·B K Owler, J D Pickard
Nov 13, 2004·Physiological Measurement·Marek CzosnykaJohn D Pickard
Jul 27, 2007·Neurologia Medico-chirurgica·Totaro TakeuchiTakashi Arai
Sep 2, 2008·Journal of Neurosurgery. Pediatrics·Paul H LeliefeldPatrick W Hanlo
Jun 21, 2001·Journal of Neurosurgery·J SoteloN Arriada
Aug 14, 2002·Acta Neurologica Scandinavica·S L M BakkerP J Koudstaal
Feb 24, 2006·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Stephen M DombrowskiMark G Luciano
May 19, 2010·Biomarkers in Medicine·Andrew TarnarisLaurence D Watkins
Nov 30, 2013·Journal of Neurosurgery. Pediatrics·Grant A Bateman
Jul 30, 2015·The Cochrane Database of Systematic Reviews·Katarina Ivana TudorJosip Car
Feb 14, 2002·Neurosurgery·Zofia H CzosnykaJohn D Pickard
Oct 24, 2009·AJNR. American Journal of Neuroradiology·C J J van AschG J E Rinkel
Nov 11, 2008·Journal of Neurosurgery·Andrew TarnarisLaurence D Watkins
Apr 5, 2007·Journal of Neurosurgery·Mark G BurnettSherman C Stein
Sep 6, 2013·Journal of Magnetic Resonance Imaging : JMRI·Doerthe ZiegelitzCarsten Wikkelsø
May 9, 2008·Neurologia Medico-chirurgica·Masatsune IshikawaHiroshi Koyama
Mar 23, 2004·Brain : a Journal of Neurology·Shahan MomjianJohn D Pickard
Apr 20, 2004·Journal of Computer Assisted Tomography·Giovanni de MarcoMarie Cécile Henry Feugeas
Apr 5, 2007·Journal of Neurosurgery·Sherman C SteinSeema S Sonnad
Jan 19, 2010·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·William C Hanigan, Donna Bogner
Mar 1, 2014·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Asem Salma
Sep 2, 2016·Neurosurgical Focus·Nicole C H KeongJohn D Pickard
Sep 2, 2016·Neurosurgical Focus·Badih DaouPascal Jabbour

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