Pressure gradients in the brain in an experimental model of hydrocephalus

OBJECT: The goal of this investigation was to establish whether pressure gradients exist between the ventricles, brain tissue, and subarachnoid space when acute or chronic hydrocephalus develops. Such gradients are hypothesized by many models of hydrocephalus, but considerable controversy continues about their existence.

METHODS: A stereotactic frame was used for surgery in dogs to implant pressure sensors within the right lateral ventricle, the frontal lobe, and forward in the subarachnoid space. The dogs were allowed to recover for 10 to 14 days postoperatively. Then, 800 mg of sterile kaolin in water was injected into the cisterna magna region by using a percutaneous approach. Both real-time and long-term intracranial pressures were measured. Of the six dogs, one experienced an intracranial hemorrhage, one dog displayed status epilepticus after a second injection of kaolin and was killed, one experienced acute hydrocephalus, and three experienced mild chronic hydrocephalus. No consistent pressure differences were found in any dog between the ventricle, brain, and subarachnoid space before kaolin administration or afterward when hydrocephalus developed. In addition, no pulse pressure gradients occurred between the brain and the ventricle or subarachnoid space.

CONCLUSIONS: Precise monitoring of pressure before and during the development of hydrocephalus did not detect pressure gradients between the ventricle, brain, and subarachnoid space. This was true for long-term measurements over weeks and for real-time measurements that allowed accurate assessment of pulse pressures. Theories predicting pressure gradients greater than the resolution of these sensors (0.5 mm Hg) across brain tissue have to be reevaluated in light of these findings.

Errataetall:

CommentIn: J Neurosurg. 2006 Jun;104(6):992-4; author reply 994. - PMID 16776351

Medienart:

Artikel

Erscheinungsjahr:

2005

Erschienen:

2005

Enthalten in:

Zur Gesamtaufnahme - volume:102

Enthalten in:

Journal of neurosurgery - 102(2005), 6 vom: 15. Juni, Seite 1069-75

Sprache:

Englisch

Beteiligte Personen:

Penn, Richard D [VerfasserIn]
Lee, Max C [VerfasserIn]
Linninger, Andreas A [VerfasserIn]
Miesel, Keith [VerfasserIn]
Lu, Steven Ning [VerfasserIn]
Stylos, Lee [VerfasserIn]

Themen:

24H4NWX5CO
Journal Article
Kaolin
Research Support, Non-U.S. Gov't

Anmerkungen:

Date Completed 10.08.2005

Date Revised 21.11.2013

published: Print

CommentIn: J Neurosurg. 2006 Jun;104(6):992-4; author reply 994. - PMID 16776351

Citation Status MEDLINE

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM156649489