Journal of Korean Neurosurgical Society

  • 제39권1호
  • /
  • Pages.20-25
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  • 2006
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
권호 표지

Transcranial Doppler and Cerebrospinal Fluid Flow Study in Normal Pressure Hydrocephalus

  • Lee, Hui-Keun (Department of Neurosurgery, Wonju College of Medicine, Yonsei University) ;
  • Hu, Chul (Department of Neurosurgery, Wonju College of Medicine, Yonsei University) ;
  • Whang, Kum (Department of Neurosurgery, Wonju College of Medicine, Yonsei University) ;
  • Kim, Hun-Joo (Department of Neurosurgery, Wonju College of Medicine, Yonsei University)
  • 발행 : 2006.01.30
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초록

Objective : The authors analyze prospectively the result of transcranial doppler[TCD] in normal pressure hydrocephalus and compared its cerebral blood flow parameters to radionuclide cerebrospinal fluid[CSF] flow study, postoperative brain computed tomography[CT] findings and clinical outcome, and studied the relationship between cerebral hemodynamics and clinical performance. Methods : Twenty five patients with hydrocephalus undertook pre- and post-operative TCD but only preoperative CSF flow study was performed. Mean flow velocity[Vm], pulsatility index[PI] and resistance index[RI] were assessed through TCD and changes in ventricle size and cortical gyral atrophy were checked through brain CT. Results : Postoperative hydrocephalus showed an increase in Vm[ACA P=0.037, MCA P=0.034], decrease in PI[ACA P=0.019, MCA P=0.017] and decrease in RI [ACA P=0.017, MCA P=0.021] compared to preoperative TCD parameters in the postoperative improvement group. In the postoperative improvement group, postoperative TCD parameters correlated with CSF flow study grade [Vm : $R^2=-0.75$, PI : $R^2=0.86$, RI : $R^2=0.78$] and ventriculocranial ratio change correlated with PI change [$R^2=0.73$]. The convexity gyral atrophy and initial TCD parameters showed close relationship to outcome. Conclusion : PI and RI can be used as an indicator of post operative prognosis, and with the addition of CSF flow study values, can also be used as a tool to predict pre-op and post-op patient status and successful shunt surgery.

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참고문헌

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