Predictive value of spinal CSF volume in the preoperative assessment of patients with idiopathic normal-pressure hydrocephalus

Znanstveni rad - Izvorni znanstveni rad

• Autor: Nenad Kudelić
• Autor: Ivan Koprek
• Autor: Milan Radoš
• Autor: Darko Orešković
• Autor: Ivana Jurjević
• Autor: Marijan Klarica
• Autorova ustanova: Sveučilište u Zagrebu; Medicinski fakultet; (HRVATSKI INSTITUT ZA ISTRAŽIVANJE MOZGA)
• Autorova ustanova: Sveučilište u Zagrebu; Medicinski fakultet; (KATEDRA ZA TEMELJNU I KLINIČKU FARMAKOLOGIJU)
• Znanstveno / umjetničko područje, polje i grana: BIOMEDICINA I ZDRAVSTVO; Temeljne medicinske znanosti; Farmakologija

Sažetak (engleski)

Introduction: The pathophysiology, diagnosis, and management of idiopathic normal pressure hydrocephalus (iNPH) remain unclear. Although some prognostic tests recommended in iNPH guidelines should have high sensitivity and high predictive value, there is often no positive clinical response to surgical treatment.

Materials and methods: In our study, 19 patients with clinical and neuroradiological signs of iNPH were selected for preoperative evaluation and possible further surgical treatment according to the guidelines. MR volumetry of the intracranial and spinal space was performed. Patients were exposed to prolonged external lumbar drainage in excess of 10 ml per hour during 3 days. Clinical response to lumbar drainage was assessed by a walk test and a mini-mental test.

Results: Twelve of 19 patients showed a positive clinical response and underwent a shunting procedure. Volumetric values of intracranial space content in responders and non-responders showed no statistically significant difference. Total CSF volume (sum of cranial and spinal CSF volumes) was higher than previously published. No correlation was found between spinal canal length, CSF pressure, and CSF spinal volume. The results show that there is a significantly higher CSF volume in the spinal space in the responder group (n = 12) (120.5 ± 14.9 ml) compared with the non-responder group (103.1 ± 27.4 ml; n = 7).

Discussion: This study demonstrates for the first time that CSF volume in the spinal space may have predictive value in the preoperative assessment of iNPH patients. The results suggest that patients with increased spinal CSF volume have decreased compliance. Additional prospective randomized clinical trials are needed to confirm our results.

• Ključne riječi (engleski): CSF volume; cranial CSF; idiopathic normal-pressure hydrocephalus; preoperative assessment; prognostic test; spinal CSF
• Jezik: engleski
• Vrsta publikacije: Znanstveni rad - Izvorni znanstveni rad
• Status objave: Objavljen
• Vrsta recenzije: Recenziran
• Verzija publikacije: Objavljena verzija rada (izdavačev PDF)
• Naslov časopisa: Frontiers in Neurology
• Brojčani podaci: vol. 14, 1234396
• e-ISSN: 1664-2295
• DOI: https://doi.org/10.3389/fneur.2023.1234396
• URN:NBN: urn:nbn:hr:105:426502
• Datum objave publikacije: 2023-10-05
• Projekt: Šifra: 108-1080231-0023; Naziv (hrvatski): Patofiziologija cerebrospinalnog likvora i intrakranijskog tlaka; Naziv (engleski): Pathophysiology of the cerebrospinal fluid and intracranial pressure; Voditelj: Marijan Klarica; Pravna nadležnost: Hrvatska; Financijer: Ministarstvo znanosti i obrazovanja Republike Hrvatske; Linija financiranja: zProjects
• Projekt: Šifra: KK.01.1.1.01.0007; Naziv (hrvatski): Eksperimentalna i klinička istraživanja hipoksijsko-ishemijskog oštećenja mozga u perinatalnoj i odrasloj dobi; Naziv (engleski): .; Kratica: ZCI Neuro; Voditelj: Miloš Judaš; Pravna nadležnost: eu; Financijer: Europska komisija; Linija financiranja: European Regional Development Fund
• URL dokumenta: https://www.frontiersin.org/articles/10.3389/fneur.2023.1234396/full
• Vrsta resursa: Tekst
• Prava pristupa: Otvoreni pristup
• Datum i vrijeme pohrane: 2024-05-17 07:45:22