Aqueductal CSF stroke volume measurements may drive management of shunted idiopathic normal pressure hydrocephalus patients

Abstract CSF shunting with adjustable valve is the treatment of idiopathic normal pressure hydrocephalus. The opening pressure valve setting is left to the neurosurgeon’s experience. Aqueductal CSF stroke volume by phase-contrast magnetic resonance measures the CSF passing through the Sylvian aquedu...

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Autores principales:	Antonio Scollato, Saverio Caini, Lucia Angelini, Giancarlo Lastrucci, Nicola Di Lorenzo, Berardino Porfirio, Pasquale Gallina
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/6074d635d24642c1937b7d610c9c9b3f
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spelling	oai:doaj.org-article:6074d635d24642c1937b7d610c9c9b3f2021-12-02T18:17:54ZAqueductal CSF stroke volume measurements may drive management of shunted idiopathic normal pressure hydrocephalus patients10.1038/s41598-021-86350-82045-2322https://doaj.org/article/6074d635d24642c1937b7d610c9c9b3f2021-03-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-86350-8https://doaj.org/toc/2045-2322Abstract CSF shunting with adjustable valve is the treatment of idiopathic normal pressure hydrocephalus. The opening pressure valve setting is left to the neurosurgeon’s experience. Aqueductal CSF stroke volume by phase-contrast magnetic resonance measures the CSF passing through the Sylvian aqueduct and it changes with intracranial hydrodynamics. We sought to identify a window of stroke volume differences associated with the best clinical outcome and lowest rate of complications. The records of 69 patients were reviewed. At every clinical check, stroke volume, opening pressure valve, clinical outcome, and CSF overdrainage were analyzed. The correlation between stroke volume differences and negative outcome was also analyzed. The median follow-up was 2.3 years (range 0.3–10.4 years). The odds of negative outcome between two consecutive checks significantly increased by 16% (95%CI 4–28%, p = 0.006). Taking the lowest risk group as reference, the odds ratio of negative outcome was 1.16 (95%CI 0.51–2.63, p = 0.726) for SV differences less than − 37.6 µL, while it was 1.96 (95%CI 0.97–3.98, p = 0.062) for stroke volume changes above + 23.1 µL. Maintaining stroke volume values within a definite range might help maximize clinical benefit and avoid the risk of CSF overdrainage.Antonio ScollatoSaverio CainiLucia AngeliniGiancarlo LastrucciNicola Di LorenzoBerardino PorfirioPasquale GallinaNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-6 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Antonio Scollato Saverio Caini Lucia Angelini Giancarlo Lastrucci Nicola Di Lorenzo Berardino Porfirio Pasquale Gallina Aqueductal CSF stroke volume measurements may drive management of shunted idiopathic normal pressure hydrocephalus patients
description	Abstract CSF shunting with adjustable valve is the treatment of idiopathic normal pressure hydrocephalus. The opening pressure valve setting is left to the neurosurgeon’s experience. Aqueductal CSF stroke volume by phase-contrast magnetic resonance measures the CSF passing through the Sylvian aqueduct and it changes with intracranial hydrodynamics. We sought to identify a window of stroke volume differences associated with the best clinical outcome and lowest rate of complications. The records of 69 patients were reviewed. At every clinical check, stroke volume, opening pressure valve, clinical outcome, and CSF overdrainage were analyzed. The correlation between stroke volume differences and negative outcome was also analyzed. The median follow-up was 2.3 years (range 0.3–10.4 years). The odds of negative outcome between two consecutive checks significantly increased by 16% (95%CI 4–28%, p = 0.006). Taking the lowest risk group as reference, the odds ratio of negative outcome was 1.16 (95%CI 0.51–2.63, p = 0.726) for SV differences less than − 37.6 µL, while it was 1.96 (95%CI 0.97–3.98, p = 0.062) for stroke volume changes above + 23.1 µL. Maintaining stroke volume values within a definite range might help maximize clinical benefit and avoid the risk of CSF overdrainage.
format	article
author	Antonio Scollato Saverio Caini Lucia Angelini Giancarlo Lastrucci Nicola Di Lorenzo Berardino Porfirio Pasquale Gallina
author_facet	Antonio Scollato Saverio Caini Lucia Angelini Giancarlo Lastrucci Nicola Di Lorenzo Berardino Porfirio Pasquale Gallina
author_sort	Antonio Scollato
title	Aqueductal CSF stroke volume measurements may drive management of shunted idiopathic normal pressure hydrocephalus patients
title_short	Aqueductal CSF stroke volume measurements may drive management of shunted idiopathic normal pressure hydrocephalus patients
title_full	Aqueductal CSF stroke volume measurements may drive management of shunted idiopathic normal pressure hydrocephalus patients
title_fullStr	Aqueductal CSF stroke volume measurements may drive management of shunted idiopathic normal pressure hydrocephalus patients
title_full_unstemmed	Aqueductal CSF stroke volume measurements may drive management of shunted idiopathic normal pressure hydrocephalus patients
title_sort	aqueductal csf stroke volume measurements may drive management of shunted idiopathic normal pressure hydrocephalus patients
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/6074d635d24642c1937b7d610c9c9b3f
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Aqueductal CSF stroke volume measurements may drive management of shunted idiopathic normal pressure hydrocephalus patients

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