Possibilities for assessing cerebral perfusion in patients with chronic disturbance of consciousness due to hydrocephalus

INTRODUCTION. Determination of indications for liquorosunting operations in patients with chronic impairment of consciousness (CHF) is an urgent problem, and the criteria for the effectiveness of surgical treatment have not been fully studied.

AIM. To determine the indications and criteria for the effectiveness of liquor shunting operations in patients with chronic impairment of consciousness.

MATERIALS AND METHODS. In Polenov Neurosurgery Institute – the branch of Almazov National Medical Research Centre in the period from 2004 to 2018, surgical treatment of patients with CNS was carried out, the decision on the need for liquorosunting surgery was made on the basis of a comprehensive clinical and intrascopic examination, since standard indications for surgery were not enough.

RESULTS. After the infusion-load test and determination of biomechanical parameters of the craniospinal system, the parameters of the valve of the shunting system were determined. Dynamics of ventricular system size in the early postoperative period was not revealed. 30 days after surgery, control CT perfusion was performed, according to which there was a significant increase in cerebral blood flow in the basal nuclei and a decrease in the average time of passage of the contrast agent.

CONCLUSION. The definition of indications for the implantation of a shunt system must have an integrated approach must consider not only the CT signs of increasing ventricular system in combination with the hypertension syndrome, but these modern methods of examination (TCD, MRI/CT perfusion, the data of infusion-load test).

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