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Transcerebral Mantle Pressure in Normal Pressure Hydrocephalus
Julian Hoff, MD;
Richard Barber, MD
Arch Neurol. 1974;31(2):101-105.
Abstract
Four patients with normal pressure hydrocephalus underwent constant infusion manometry during general anesthesia to determine their cerebrospinal fluid (CSF) absorption capacity. Before and during lumbar saline infusion, intraventricular (ICPV), subdural (ICPSD), and lumbar sac pressures were monitored continuously. The ICPV rose progressively in all four without equilibration of saline infusion and CSF absorption. A pressure gradient between the ventricle and the subdural space (ICPV> ICPSD), barely evident before infusion, increased as ICPV rose in three of the four. Two additional patients without ventricular dilation, failed to show a pressure gradient across the cerebral mantle within the measured ICPV range (10 to 30 mm Hg). A pressure gradient across the cerebral mantle may contribute to ventricular dilation in normal pressure hydrocephalus.
Author Affiliations
San Francisco
From the departments of neurological surgery (Dr. Hoff) and anesthesiology (Dr. Barber), San Francisco General Hospital, University of California School of Medicine, San Francisco.
Footnotes
Accepted for publication Dec 5, 1973.
Reprint requests to Department of Neurological Surgery, University of California School of Medicine, San Francisco, CA 94143 (Dr. Hoff).
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