Cerebrospinal fluid pressure dynamics

Abstract

Although hydrocephalus is much more than CSF dynamics disorder, components of disturbed CSF circulation and volume-pressure compensation are omnipotent in almost all types of this disease. CSF infusion test or overnight ICP monitoring are two most common procedures used in clinical practice to diagnose deranged CSF dynamics. Both are invasive but they have lot of advantages over CSF flow measurement methods based on MRI. Increased baseline ICP level, raised resistance to CSF outflow, increased brain elasticity, abnormally high magnitude of ICP slow vasogenic waves and ICP pulse amplitude, and increased slope of amplitude-pressure line or depleted compensatory reserve are all listed as an evidence of disturbed CSF dynamics. Moreover, infusion test through the shunt pre-chamber is a useful and reliable method for assessment shunt functioning in vivo, which helps to avoid unnecessary shunt revisions.