학술논문

Hydrocephalus and the neuro-intensivist: CSF hydrodynamics at the bedside.
Document Type
Article
Source
Intensive Care Medicine Experimental. 5/27/2022, Vol. 10 Issue 1, p1-16. 16p.
Subject
*HYDROCEPHALUS
*HYDRODYNAMICS
*CEREBRAL circulation
*INTRACRANIAL pressure
*CEREBRAL atrophy
Language
ISSN
2197-425X
Abstract
Hydrocephalus (HCP) is far more complicated than a simple disorder of cerebrospinal fluid (CSF) circulation. HCP is a common complication in patients with subarachnoid hemorrhage (SAH) and after craniectomy. Clinical measurement in HCP is mainly related to intracranial pressure (ICP) and cerebral blood flow. The ability to obtain quantitative variables that describe CSF dynamics at the bedside before potential shunting may support clinical intuition with a description of CSF dysfunction and differentiation between normal pressure hydrocephalus and brain atrophy. This review discusses the advanced research on HCP and how CSF is generated, stored and absorbed within the context of a mathematical model developed by Marmarou. Then, we proceed to explain the main quantification analysis of CSF dynamics using infusion techniques for deciding on definitive treatment. We consider that such descriptions of multiple parameters of measurements need to be significantly appreciated by the caring neuro-intensivist, for better understanding of the complex pathophysiology and clinical management and finally, improve of the prognosis of these patients with HCP. Take home message: In this review article, we present current and novel theories of CSF circulation and pathophysiology of hydrocephalus, along with results from infusion studies for evaluating CSF dynamics at the bedside. [ABSTRACT FROM AUTHOR]