CBF evaluation as a diagnostic tool in hydrocephalus

Kiefer, M.; Eymann, Regina; Voges, M.; Hermes, M.; Steudel, Wolf-Ingo

doi:10.1016/s0303-8467(97)82512-7

Cited by 3 publications

(2 citation statements)

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“…To record the clinical state of each patient, we applied the Homburg Hydrocephalus Scale (HHS) ( Table 1); it has been described in detail elsewhere (29,31,36,48). The recovery index (RI) derived on this basis is:…”

Section: Documentationmentioning

confidence: 99%

Gravitational Shunts in Longstanding Overt Ventriculomegaly in Adults

et al. 2005

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Unlike conventional differential pressure shunts, gravitational shunts can be used in the treatment of high-risk patients with longstanding overt ventriculomegaly in adults. Significant risk of overdrainage can be avoided. Gravitational shunts offer a viable alternative to endoscopic third ventriculostomy, provided the choice and adjustment of the shunt opening pressure is based on a correct assessment of the hydrostatic pressure to be compensated for.

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Section: Documentationmentioning

confidence: 99%

Gravitational Shunts in Longstanding Overt Ventriculomegaly in Adults

et al. 2005

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“…Unter diesen Umständen besteht auch kein Zweifel, dass der transmurale Druck, der vom Ventrikel ausgeht und auf das Hirngewebe einwirkt, ebenfalls pathologisch ist. Folge hiervon ist, dass die Hirndurchblutung im mikrovaskulären Bereich leidet [27] und mit ihr der zellulä-re Stoffwechsel. Dies führt vielleicht primär nur zu einem funktionellen Schaden der Zellen.…”

Section: Diskrepanz Zwischen Bildmorphologischen Befunden Und Kliniscunclassified

LOVA-Hydrozephalus

Kiefer¹,

Eymann²,

Steudel³

2002

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The recently defined term "longstanding overt ventriculomegaly in adults" (LOVA) describes a unique entity of chronic occlusive hydrocephalus. The experiences so far using conventional DP valves were not encouraging because of a high percentage of overdrainage. The objective was to evaluate whether gravitational shunts could be used for this condition with an acceptable overdrainage risk. Twenty-three macrocephalic adults aged 17-72 years suffered from chronic progressive hydrocephalic conditions. They received two different types of gravitational shunt. Follow-up ranged from 6 months to 75 months. Only two patients presented small subdural effusions postoperatively, and only one required additional treatment for that. Eighty-two percent were shunt responders. Ventricular size was only marginally reduced in 22 of the 23 patients. There was no correlation between clinical benefit and the reduction in ventricular size. Gravitational shunts clearly have the potency for safe treatment of LOVA, significantly reducing the risk of overdrainage over conventional valves, and may be considered an equivalent alternative to third ventriculostomy.

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