The diagnostic value of the pulsatility curve to predict shunt responsiveness in patients with idiopathic normal pressure hydrocephalus

M. W.T. van Bilsen*, L. van den Abbeele, V. Volovici, H. D. Boogaarts, R. H.M.A. Bartels, E. J. van Lindert

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Downloads (Pure)

Abstract

Objective: The aim of this study was to investigate the diagnostic accuracy of the pulsatility curve to predict shunt response in patients with idiopathic normal pressure hydrocephalus (iNPH). Methods: Lumbar cerebrospinal fluid dynamics were derived from an automatic lumbar infusion test (LIT) protocol. All patients were treated with ventriculoperitoneal shunting and re-examined 6 months after shunting. Patient demographics and outcomes were gathered in a prospective, electronic database that spanned from January 2012 to January 2020. A validated iNPH scale was used to assess patients preoperatively and 6 months postoperatively. The relationship of the relative pulse pressure coefficient (RPPC), delta amplitude, successful lowering of amplitude, and the pressure-value at a hypothetical amplitude of zero (P0), resistance to outflow (Rout), and outcome, were assessed using receiver operating characteristic (ROC) curves. Results: We included 38 patients. The RPPC, delta amplitude, successful lowering of amplitude, and P0 parameters did not predict shunt response. Mean P0 was 0.5 (IQR 0.4–0.9) in improved patients and 0.4 (IQR 0–1.2) in non-improved patients. The delta amplitude was 0.16 kPa (IQR 0.10–0.23) in improved patients and 0.18 kPa (IQR 0.11–0.24) in non-improved patients. Furthermore, we found a technical failure rate of pulsatility curve measurements of 32%. Conclusion: Pulsatility curve results were not suitable in predicting shunt response in our cohort. The diagnostic value of LIT in case of normal pressure hydrocephalus should be subject to more rigorous research.

Original languageEnglish
Pages (from-to)1747-1754
Number of pages8
JournalActa Neurochirurgica
Volume164
Issue number7
Early online date30 May 2022
DOIs
Publication statusPublished - Jul 2022

Bibliographical note

Publisher Copyright:
© 2022, The Author(s).

Fingerprint

Dive into the research topics of 'The diagnostic value of the pulsatility curve to predict shunt responsiveness in patients with idiopathic normal pressure hydrocephalus'. Together they form a unique fingerprint.

Cite this