Preview

Russian Neurosurgical Journal named after Professor A. L. Polenov

Advanced search

Diagnostic options in premature infants with hydrocephalus. Criteria for restoring the brain mantle

https://doi.org/10.56618/2071-2693_2024_16_2_23

EDN: OHDSPY

Abstract

INTRODUCTION. A modern assessment of the state of the brain and cerebrospinal fluid (CSF) communications in hydrocephalus in premature infants should include characteristics of outflow – absorption of CSF and the reactivity of brain tissue to pressure increase with increasing intracranial and cerebrospinal volume.

AIM. To study hydrocephalus in premature infants.

MATERIALS AND METHODS. The use of craniocerebral elastogram (CCE) with infusion hydrodynamic load (IHL) tests in 143 premature infants with hydrocephalus since 2008 has been studied. The effectiveness of restoring intracranial pressure (ICP) was evaluated, taking into account the volume of rapid (12–18 ml/min) and slow (18–27 ml/hour) movements of the CSF.

Results. An increase in ICP of more than 50 % reflected the lack of recovery of CSF outflow from the ventricles (after the ventricular IHL test) and resistant absorption (after the lumbar IHL) with the justification of indications for ventricularperitoneal bypass. With a decrease in CCE to 3 cm3/mm water pressure there was a residual expansion of the ventricular system with a ventricular index greater than 0.5, and below 1 cm3/mm water pressure irreversible changes in brain tissue without restoring the thickness of the brain mantle.

CONCLUSION. The data obtained make it possible to use the options of CCE and IHL in the diagnosis of hydrocephalus in premature infants, expand the possibilities of assessing the state of the brain and CSF communications with a characteristic of the effectiveness of outflow and absorption of CSF. 

About the Authors

O. V. Volkodav
Crimean Federal University
Russian Federation

Oleg V. Volkodav – Cand. of Sci. (Med.), Associate Professor at the Department of Nervous Diseases and Neurosurgery

5/7 Lenin Boulevard, Simferopol, 295051



S. A. Zinchenko
Crimean Federal University
Russian Federation

Svetlana A. Zinchenko – Cand. of Sci. (Med.), Associate Professor at the Department of Normal Physiology

5/7 Lenin Boulevard, Simferopol, 295051



K. A. Samochernykh
Polenov Neurosurgery Institute – the branch of Almazov National Medical Research Centre
Russian Federation

Konstantin A. SamochernykhDr. of Sci. (Med.), Professor of the Russian Academy of Sciences, Neurosurgeon of the Highest Category at the Department of Neurosurgery for Children No. 7, Director

12 Mayakovskogo street, St. Petersburg, 191025



W. A. Khachatryan
Polenov Neurosurgery Institute – the branch of Almazov National Medical Research Centre
Russian Federation

William А. Khachatryan – Dr. of Sci. (Med.), Full Professor, Chief Researcher at the Research Institute of Pediatric Neurosurgery

12 Mayakovskogo street, St. Petersburg, 191025



References

1. Marmarou A. A., Shulman K., Rosende R. M. Nonlinear Analysis of the Cerebrospinal Fluid System and Intracranial Pressure Dynamics. J neurosurg. 1978;(48):332–344. Doi: 10.3171/jns.1978.48.3.0332.

2. Davson H., Welch K., Segal M. B. The physiology and pathophysiology of cerebrospinal fluid. Churchill Livingstone. N. Y.; 1987. Doi: 10.1177/088307388800300414.

3. Czosnyka M., Czosnyka Z. H., Whitfield P. C., Pickard J. D. Cerebrospinal Fluid Dynamics. Pediatric Hydrocephalus; eds by W. J. Maixner, C. Sainte-Rose. Springer-Verlag Italia, Milano; 2004, pp. 47–63. Doi: 10.1088/0967-3334/25/5/r01.

4. Miyajima M., Arai H. Evaluation of the Production and Absorption of Cerebrospinal Fluid. Neurol Med Chir. 2015;55(8):647–656. Doi: 10.2176/nmc.ra.2015-0003.

5. Albeck M. J., Skak C., Nielsen P. R. et al. Age dependency of resistance to cerebrospinal fluid outflow. J Neurosurg. 1998;89(2):275–278. Doi: 10.3171/jns.1998.89.2.0275.

6. Whiteley W., Al-Shahi R., Warlow C. P. CSF opening pressure: reference interval and the effect of body mass index. Neurology. 2006;(67):1690–1691. Doi: 10.1212/01.wnl.0000242704.60275.e9.

7. Stoquart-ElSankari S., Baludent O., Gondry-Jouet C. et al. Aging effects on cerebral blood and cerebrospinal fluid flows J Cereb Blood Flow Metab. 2007;27(9):1563–1572. Doi: 10.1038/sj.jcbfm.9600462.

8. Symss N. P., Oi S. Theories of cerebrospinal fluid dynamics and hydrocephalus: historical trend. J Neurosurg Pediatr. 2013;11(2):170–177. Doi: 10.3171/2012.3.PEDS0934.

9. Volkodav O. V., Zinchenko S. A., Khachatryan V. A. Craniocerebral elasticity and infusion load test in premature infants with decompensation of hydrocephalus. Russian neurosurgical journal named after professor A. L. Polenov. 2022;14(1– 1):17–20. (In Russ.)]. eLIBRARY ID: 48217854.

10. Robinson S. Neonatal posthemorrhagic hydrocephalus from prematurity: pathophysiology and current treatment concepts. J Neurosurg Pediatr. 2012;9(3):242–258. Doi: 10.3171/2011.12.PEDS11136.

11. Patent No. 2786321. RU. Method for the diagnosis of the CSF dynamic disorder in premature infants; Volkodav O. V. Publ. 20.12.2022. Bul. № 35 (In Russ.). Available from: https://patenton.ru›patent›RU2786321C1 [Accessed 18. February 2024].

12. Whitelaw A., Lee-Kelland R. Repeated lumbar or ventricular punctures in newborns with intraventricular haemorrhage. Cochrane Database Syst Rev. 2017;(6):4. Doi: 10.1002/14651858.CD000216.pub2.

13. Atiskov Yu. A., Samochernykh K. A., Khachatryan V. A. Estimation of craniospinal compliance. Russian journal of neurosurgery. 2017;(4):42–49. (In Russ.)]. Doi: https://doi.org/www.therjn.com.

14. Samochernykh N. K., Abramov K. B., Nikolaenko M. S., Sakhno L. V., Samochernykh K. A., Potemkina E. G. The treatment of patients with posthemorrhagic hydrocephalus. Rossiyskiy Vestnik Perinatologii i Pediatrii. 2021;66(5):97–104. (In Russ.)]. Doi: 10.21508/1027–4065–2021–66–5–97–104.

15. Mazzola C. A., Choudhri A. F., Auguste K. I. et al. Pediatric hydrocephalus: systematic literature review and evidence-based guidelines. P. 2: Management of posthemorrhagic hydrocephalus in premature infants. J Neurosurg Pediatr. 2014;14(1):8–23. Doi: 10.3171/2014.7.PEDS14322.

16. Melo J. R. T., Passos R. K., Carvalho M. L. C. Cerebrospinal fluid drainage options for posthemorrhagic hydrocephalu s in premature neonates. Arq Neurops. 2017;75(7):433–438. Doi: 10.1590/0004-282X20170060.

17. Tan A. P., Svrckova P., Cowan F. Intracranial hemorrhage in neonates: A review of etiologies, patterns and predicted clinical outcomes. Eur J Paediatr Neurol. 2018;22(4):690–717. Doi: 10.1016/j.ejpn.2018.04.008.

18. Pediatric neurosurgery: National guidelines; eds by K. A. Samochernykh. SPb.: PZR; 2024. 576 p. (In Russ.)].


Review

For citations:


Volkodav O.V., Zinchenko S.A., Samochernykh K.A., Khachatryan W.A. Diagnostic options in premature infants with hydrocephalus. Criteria for restoring the brain mantle. Russian Neurosurgical Journal named after Professor A. L. Polenov. 2024;16(2):23-31. (In Russ.) https://doi.org/10.56618/2071-2693_2024_16_2_23. EDN: OHDSPY

Views: 49


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2071-2693 (Print)