Titre du document / Document title

Diamox® challenge test to decide indications for cerebrospinal fluid shunting in normal pressure hydrocephalus. Commentaries

Auteur(s) / Author(s)

MIYAKE H. ⁽¹⁾ ; OHTA T. ⁽¹⁾ ; KAJIMOTO Y. ⁽¹⁾ ; DEGUCHI J. ⁽¹⁾ ; CZERNICKI Z. (Commentateur) ; BORGESEN E. (Commentateur) ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Department of Neurosurgery, Osaka Medical College, JAPON

Résumé / Abstract

Objective. The indications for cerebrospinal fluid (CSF) shunting in patients with normal pressure hydrocephalus (NPH) have not been established. Establishment of clear-cut indications for this procedure is essential to ensure cost-effective, and safe treatment. We report the usefulness of the Diamox ^R challenge test in evaluating indications for CSF shunting in patients with NPH. Methods. Pre- and post-operative responses in cerebral blood flow (CBF) and intracranial pressure (ICP) to intravenous administration of Diamox ^R 1000 mg ( Diamox ^R administration) were analysed in 41 patients with NPH who were treated by ventriculoperitoneal (VP) shunt with a programmable valve and an on-off valve. Results. The preoperative response of ICP to Diamox^R administration was more than 10 mmHg in most patients in whom the shunt was effective (shunt effective group), however, it was less than 10 mmHg in most patients in whom the shunt was ineffective (shunt non-effective group). Furthermore, the postoperative response of ICP to Diamox^R administration decreased to less than 10 mmHg in most patients in the shunt effective group. The increases in CBF in response to Diamox^R administration were similar in the two groups both before and after placement of the VP shunt. Conclusion. Patients in whom ICP increased by more than 10 mmHg in response to Diamox^R administration were regarded to have poor CSF circulation and to thus be candidates for CSF shunting. The Diamox^R challenge test is a simple, safe procedure, useful in evaluating the response to treatment.

Revue / Journal Title

Acta neurochirurgica   ISSN 0001-6268   CODEN ACNUA5 

Source / Source

1999, vol. 141, n^o11, pp. 1187-1193 (22 ref.)

Langue / Language

Anglais

Editeur / Publisher

Springer, Wien, AUTRICHE  (1950) (Revue)

Mots-clés anglais / English Keywords

Normal pressure hydrocephaly ; Bypass ; Cerebrospinal fluid ; Acetazolamide ; Intravenous administration ; Treatment ; Indication ; Human ; Sulfonamide ; Nervous system diseases ; Central nervous system disease ; Cerebral disorder ; Surgery ; Route of administration ;

Mots-clés français / French Keywords

Hydrocéphalie occulte pression normale ; Dérivation ; Liquide céphalorachidien ; Acétazolamide ; Voie intraveineuse ; Traitement ; Indication ; Homme ; Sulfonamide ; Système nerveux pathologie ; Système nerveux central pathologie ; Encéphale pathologie ; Chirurgie ; Voie administration ;

Mots-clés espagnols / Spanish Keywords

Hidrocefalia oculta presión normal ; Derivación ; Líquido cefalorraquídeo ; Acetazolamida ; Vía intravenosa ; Tratamiento ; Indicación ; Hombre ; Sulfonamida ; Sistema nervioso patología ; Sistema nervosio central patología ; Encéfalo patología ; Cirugía ; Vía administración ;

Localisation / Location

INIST-CNRS, Cote INIST : 7169, 35400008026487.0070