Abstract
Objective Shunt failure is common in hydrocephalic patients. The cerebrospinal fluid (CSF) infusion test enables the assessment of CSF absorption capacity, which is represented by the resistance to CSF outflow (ROUT) However, shunt failure may not only affect the CSF absorption capacity but also the intracranial compliance or compensatory properties. Spectral analysis of the ICP signal obtained during the infusion test may enable the comprehensive assessment of the overall deterioration caused by shunt failure. Material and methods A total of 121 hydrocephalic shunted patients underwent the infusion test with continuous intracranial pressure (ICP) and arterial blood pressure (ABP) recording. The maximum amplitudes of three major frequency bandwidths (0.2-2.6, 2.6-4.0 and 4.0-15 Hz, respectively) were calculated from the ICP. Statistical analyses were conducted to identify factors significantly associated with shunt failure, to construct an index (i.e., the shunt response parameter, SRP) for detecting shunt failure, and to define thresholds for ROUT and SRP. Results The ROUT threshold for detecting shunt failure was 7.59 mmHg/ml/min, and this threshold showed an accuracy of 82.64%. All spectral parameters were found to be significantly associated with shunt patency (p <0.05). The SRP exhibited significantly better accuracy than ROUT in detecting shunt failure (91.74%). Conclusion The hydrodynamic assessment of shunted patients enhanced by spectral analysis during the infusion test detected shunt failure with high accuracy. Although further validation is needed, the SRP exhibited promising results.
| Original language | English |
|---|---|
| Pages (from-to) | 112-119 |
| Number of pages | 8 |
| Journal | Clinical Neurology and Neurosurgery |
| Volume | 142 |
| DOIs | |
| Publication status | Published - 2016 Mar 1 |
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Keywords
- Cerebrospinal fluid
- Hydrocephalus
- Infusion testa
- Shunt
- Waveform analysis
ASJC Scopus subject areas
- Clinical Neurology
- Surgery
Cite this
Spectral analysis of intracranial pressure : Is it helpful in the assessment of shunt functioning in-vivo? / Kim, Dong Ju; Kim, Hakseung; Jeong, Eun Jin; Lee, Hack Jin; Czosnyka, Marek; Son, Yunsik; Kim, Byung Jo; Czosnyka, Zofia.
In: Clinical Neurology and Neurosurgery, Vol. 142, 01.03.2016, p. 112-119.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Spectral analysis of intracranial pressure
T2 - Is it helpful in the assessment of shunt functioning in-vivo?
AU - Kim, Dong Ju
AU - Kim, Hakseung
AU - Jeong, Eun Jin
AU - Lee, Hack Jin
AU - Czosnyka, Marek
AU - Son, Yunsik
AU - Kim, Byung Jo
AU - Czosnyka, Zofia
PY - 2016/3/1
Y1 - 2016/3/1
N2 - Objective Shunt failure is common in hydrocephalic patients. The cerebrospinal fluid (CSF) infusion test enables the assessment of CSF absorption capacity, which is represented by the resistance to CSF outflow (ROUT) However, shunt failure may not only affect the CSF absorption capacity but also the intracranial compliance or compensatory properties. Spectral analysis of the ICP signal obtained during the infusion test may enable the comprehensive assessment of the overall deterioration caused by shunt failure. Material and methods A total of 121 hydrocephalic shunted patients underwent the infusion test with continuous intracranial pressure (ICP) and arterial blood pressure (ABP) recording. The maximum amplitudes of three major frequency bandwidths (0.2-2.6, 2.6-4.0 and 4.0-15 Hz, respectively) were calculated from the ICP. Statistical analyses were conducted to identify factors significantly associated with shunt failure, to construct an index (i.e., the shunt response parameter, SRP) for detecting shunt failure, and to define thresholds for ROUT and SRP. Results The ROUT threshold for detecting shunt failure was 7.59 mmHg/ml/min, and this threshold showed an accuracy of 82.64%. All spectral parameters were found to be significantly associated with shunt patency (p <0.05). The SRP exhibited significantly better accuracy than ROUT in detecting shunt failure (91.74%). Conclusion The hydrodynamic assessment of shunted patients enhanced by spectral analysis during the infusion test detected shunt failure with high accuracy. Although further validation is needed, the SRP exhibited promising results.
AB - Objective Shunt failure is common in hydrocephalic patients. The cerebrospinal fluid (CSF) infusion test enables the assessment of CSF absorption capacity, which is represented by the resistance to CSF outflow (ROUT) However, shunt failure may not only affect the CSF absorption capacity but also the intracranial compliance or compensatory properties. Spectral analysis of the ICP signal obtained during the infusion test may enable the comprehensive assessment of the overall deterioration caused by shunt failure. Material and methods A total of 121 hydrocephalic shunted patients underwent the infusion test with continuous intracranial pressure (ICP) and arterial blood pressure (ABP) recording. The maximum amplitudes of three major frequency bandwidths (0.2-2.6, 2.6-4.0 and 4.0-15 Hz, respectively) were calculated from the ICP. Statistical analyses were conducted to identify factors significantly associated with shunt failure, to construct an index (i.e., the shunt response parameter, SRP) for detecting shunt failure, and to define thresholds for ROUT and SRP. Results The ROUT threshold for detecting shunt failure was 7.59 mmHg/ml/min, and this threshold showed an accuracy of 82.64%. All spectral parameters were found to be significantly associated with shunt patency (p <0.05). The SRP exhibited significantly better accuracy than ROUT in detecting shunt failure (91.74%). Conclusion The hydrodynamic assessment of shunted patients enhanced by spectral analysis during the infusion test detected shunt failure with high accuracy. Although further validation is needed, the SRP exhibited promising results.
KW - Cerebrospinal fluid
KW - Hydrocephalus
KW - Infusion testa
KW - Shunt
KW - Waveform analysis
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U2 - 10.1016/j.clineuro.2016.01.023
DO - 10.1016/j.clineuro.2016.01.023
M3 - Article
VL - 142
SP - 112
EP - 119
JO - Clinical Neurology and Neurosurgery
JF - Clinical Neurology and Neurosurgery
SN - 0303-8467
ER -