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Assessment of CSF Dynamics Using Infusion Study: Tips and Tricks.

Authors :
Jannelli, Gianpaolo
Calvanese, Francesco
Pirina, Alessandro
Gergelé, Laurent
Vallet, Alexandra
Palandri, Giorgio
Czosnyka, Marek
Czosnyka, Zofia
Manet, Romain
Source :
World Neurosurgery. Sep2024, Vol. 189, p33-41. 9p.
Publication Year :
2024

Abstract

Idiopathic normal pressure hydrocephalus, secondary chronic hydrocephalus, and other cerebrospinal fluid (CSF) disorders are often challenging to diagnose. Since shunt surgery is usually the only therapeutic option and carries significant morbidity, optimal patient selection is crucial. The tap test is the most commonly used prognostic test to confirm the diagnosis but lacks sensitivity. The lumbar infusion study (LIS) appears to be a better option, offering additional information on brain dynamics without increasing morbidity. However, this technique remains underused. In this narrative review, supported by the extensive experience of several European expert centers, we detail the physiological basis, indications, and CSF dynamics parameters that can be measured. We also discuss technical modalities and variations, including one versus 2 needles, patient positioning, and the site of CSF measurement, as well as in vivo shunt testing. Finally, we discuss the limitations and morbidity associated with the LIS. This review aims to assist teams wishing to incorporate LIS into their screening tools for chronic hydrocephalus and other CSF disorders. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
18788750
Volume :
189
Database :
Academic Search Index
Journal :
World Neurosurgery
Publication Type :
Academic Journal
Accession number :
179500179
Full Text :
https://doi.org/10.1016/j.wneu.2024.05.131