Abstract
In hydrocephalic infants the advance of the shunting procedure improved their survival rate. Some cases, however carefully the patients were managed, showed poor prognosis. The purpose of this study is to clarify the relationship between the ventricular fluid pressure (VFP) and the post operative course in hydrocephalic infants.
Twenty-three hydrocephalic infants with marked by dilated ventricles were studied; all of them underwent continuous monitoring of VFP by means of an intra-ventricular catheter connected to an externally placed pressure transducer and an amplifier chart recorder. A test injection of 5 ml of physiological saline solution was also made through the ventricular catheter and the resulting change in VFP was observed.
The results are as follows: 1) CSF pulse wave; most of the hydrocephalic patients showed simple and monophasic wave form and the amplitude depended on the mean pressure except for fatal hydrocephalic infants. 2) Resting pressure; during long term continuous monitoring resting VFP in survival cases showed various kinds of pressure waves such as Lundberg's A wave, but in some total cases with extremely dilated ventricles, there was no noticeable fluctuation. 3) Volume induced change of VFP; in most hydrocephalic infants, the raised VFP caused by the injection of 5 ml of saline showed delayed falling.
Continuous monitoring of VFP and its analysis in hydrocephalic infants may help to decide their indication of the shunting procedure.
