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Diagnosis and Treatment of Low Intracranial Pressure Hydrocephalus

Received: 20 March 2017     Accepted: 10 April 2017     Published: 23 October 2017
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Abstract

Objective: To explore the clinical symptoms, diagnosis and treatment of low intracranial pressure hydrocephalus (LPH). Methods: The ventriculo-peritoneal shunt (VPS) with pressure-adjustable valves was performed in 5 patients with LPH. The diagnosis of LPH in 2 patient was definitely made by lumbar puncture drainage before VPS. LPH developed in other 3 patients with normal pressure hydrocephalus during the following-up which the patients’ symptoms were not improved. Results: The following-up from 3 to 31 months after VPS showed that the clinical symptoms were improved and the enlarged ventricles significantly retracted in all patients. Conclusions: LPH is uncommon and occultly comes on. LPH is similar to normal pressure hydrocephalus in the clinical manifestation. CT and MRI show that there is ventriculomegaly in all the patients with LPH and periventricular edema in some patients with LPH. VPS with pressure-adjustable valve is an effective method to treat LPH. The perfect threshold value of pressure adjustable valves, which is suitable for the individual, may be got by more than once adjustment and long-term observation of the curative effect.

Published in International Journal of Neurologic Physical Therapy (Volume 3, Issue 4)
DOI 10.11648/j.ijnpt.20170304.13
Page(s) 35-37
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2017. Published by Science Publishing Group

Keywords

Low Pressure Hydrocephalus(LPH), Ventriculo-Peritoneal Shunt, Pressure-Adjustable Valves

References
[1] Pang D, Altschuler E. Low-pressure hydrocephalic state and viscoelastic alterations in the brain. Neurosurgery.1994 Oct; 35(4):643-55; discussion 655-6.
[2] Singounas EG, Krasanakis C, Karvounis PC. Observations on the pathogenesis of low pressure hydrocephalus. Analysis of 25 cases. Neurochirurgia (Stuttg).1976 Jan; 19(1):22-5.
[3] Vassilyadi M, Farmer JP, Montes JL. Negative-pressure hydrocephalus. J Neurosurg.1995 Sep; 83(3):486-90.
[4] Adams RD, Fisher CM, Hakim S, Ojemann RG, Sweet WH. Symptomatic occult hydrocephlus with "normal" cerebrospinal-fluid pressure: a treatable syndrome [J]. N Engl J Med. 1965 Jul 15; 273:117-26.
[5] Ingram TT. 'Low-pressure hydrocephalus'. Dev Med Child Neurol.1971 Oct; 13(5):676.
[6] Owler BK, Jacobson EE, Johnston IH. Low pressure hydrocephalus: issues of diagnosis and treatment in five cases. Br J Neurosurg.2001 Aug;15(4):353-9.
[7] Filippidis AS, Kalani MY, Nakaji P, Rekate HL. Negative-pressure and low-pressure hydrocephalus: the role of cerebrospinal fluid leaks resulting from surgical approaches to the cranial base. J Neurosurg.2011 Nov; 115(5):1031-7. doi: 10.3171/2011.6. JNS101504. Epub 2011 Jul 29.
[8] Zemack G, Romner B. Adjustable valves in normal-pressure hydrocephalus: a retrospective study of 218 patients. Neurosurgery.2002 Dec; 51(6):1392-400; discussion 1400-2.
[9] Michelle J, Clarke, Cormac O, et al. Very low pressure hydrocephalus: report of two cases [J]. J Neurosurg, 2006, 105(3): 475-478.
[10] Sato H, Koizumi T, Sato D, Endo S, Kato S. Unilateral Posterior Reversible Encephalopathy Syndrome after Ventriculo-Peritoneal Shunt for Normal Pressure Hydrocephalus Following Subarachnoid Hemorrhage: A Case Report. No Shinkei Geka. 2016 Jun; 44(6):507-15.
[11] Takahashi Y, Kawanami T, Nagasawa H, Iseki C, Hanyu H, Kato T. Familial normal pressure hydrocephalus (NPH) with an autosomal-dominant inheritance: a novel subgroup of NPH. J Neurol Sci. 2011 Sep 15; 308(1-2):149-51.
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  • APA Style

    Xuejian Wang, Zhifeng Wang, Yang Chen. (2017). Diagnosis and Treatment of Low Intracranial Pressure Hydrocephalus. International Journal of Neurologic Physical Therapy, 3(4), 35-37. https://doi.org/10.11648/j.ijnpt.20170304.13

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    ACS Style

    Xuejian Wang; Zhifeng Wang; Yang Chen. Diagnosis and Treatment of Low Intracranial Pressure Hydrocephalus. Int. J. Neurol. Phys. Ther. 2017, 3(4), 35-37. doi: 10.11648/j.ijnpt.20170304.13

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    AMA Style

    Xuejian Wang, Zhifeng Wang, Yang Chen. Diagnosis and Treatment of Low Intracranial Pressure Hydrocephalus. Int J Neurol Phys Ther. 2017;3(4):35-37. doi: 10.11648/j.ijnpt.20170304.13

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  • @article{10.11648/j.ijnpt.20170304.13,
      author = {Xuejian Wang and Zhifeng Wang and Yang Chen},
      title = {Diagnosis and Treatment of Low Intracranial Pressure Hydrocephalus},
      journal = {International Journal of Neurologic Physical Therapy},
      volume = {3},
      number = {4},
      pages = {35-37},
      doi = {10.11648/j.ijnpt.20170304.13},
      url = {https://doi.org/10.11648/j.ijnpt.20170304.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijnpt.20170304.13},
      abstract = {Objective: To explore the clinical symptoms, diagnosis and treatment of low intracranial pressure hydrocephalus (LPH). Methods: The ventriculo-peritoneal shunt (VPS) with pressure-adjustable valves was performed in 5 patients with LPH. The diagnosis of LPH in 2 patient was definitely made by lumbar puncture drainage before VPS. LPH developed in other 3 patients with normal pressure hydrocephalus during the following-up which the patients’ symptoms were not improved. Results: The following-up from 3 to 31 months after VPS showed that the clinical symptoms were improved and the enlarged ventricles significantly retracted in all patients. Conclusions: LPH is uncommon and occultly comes on. LPH is similar to normal pressure hydrocephalus in the clinical manifestation. CT and MRI show that there is ventriculomegaly in all the patients with LPH and periventricular edema in some patients with LPH. VPS with pressure-adjustable valve is an effective method to treat LPH. The perfect threshold value of pressure adjustable valves, which is suitable for the individual, may be got by more than once adjustment and long-term observation of the curative effect.},
     year = {2017}
    }
    

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  • TY  - JOUR
    T1  - Diagnosis and Treatment of Low Intracranial Pressure Hydrocephalus
    AU  - Xuejian Wang
    AU  - Zhifeng Wang
    AU  - Yang Chen
    Y1  - 2017/10/23
    PY  - 2017
    N1  - https://doi.org/10.11648/j.ijnpt.20170304.13
    DO  - 10.11648/j.ijnpt.20170304.13
    T2  - International Journal of Neurologic Physical Therapy
    JF  - International Journal of Neurologic Physical Therapy
    JO  - International Journal of Neurologic Physical Therapy
    SP  - 35
    EP  - 37
    PB  - Science Publishing Group
    SN  - 2575-1778
    UR  - https://doi.org/10.11648/j.ijnpt.20170304.13
    AB  - Objective: To explore the clinical symptoms, diagnosis and treatment of low intracranial pressure hydrocephalus (LPH). Methods: The ventriculo-peritoneal shunt (VPS) with pressure-adjustable valves was performed in 5 patients with LPH. The diagnosis of LPH in 2 patient was definitely made by lumbar puncture drainage before VPS. LPH developed in other 3 patients with normal pressure hydrocephalus during the following-up which the patients’ symptoms were not improved. Results: The following-up from 3 to 31 months after VPS showed that the clinical symptoms were improved and the enlarged ventricles significantly retracted in all patients. Conclusions: LPH is uncommon and occultly comes on. LPH is similar to normal pressure hydrocephalus in the clinical manifestation. CT and MRI show that there is ventriculomegaly in all the patients with LPH and periventricular edema in some patients with LPH. VPS with pressure-adjustable valve is an effective method to treat LPH. The perfect threshold value of pressure adjustable valves, which is suitable for the individual, may be got by more than once adjustment and long-term observation of the curative effect.
    VL  - 3
    IS  - 4
    ER  - 

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Author Information
  • Department of Neurosurgery, The Second Hospital Affiliated to Nantong University, Nantong University, Nantong, PR China

  • Department of Neurosurgery, The Second Hospital Affiliated to Nantong University, Nantong University, Nantong, PR China

  • Department of Neurosurgery, The Second Hospital Affiliated to Nantong University, Nantong University, Nantong, PR China

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