J.Jpn. Surg. Soc.. 79(8): 872-877, 1978
Report on the annual meeting
SYMPOSIUM 2
3. THE THERAPEUTIC PROBLEMS OF THE HYDROCEPHALUS IN HIGH PRESSURE STADIUM
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Department of Neurosurgery, Tokyo Medical College Hospital Tetsuro Miwa, Hiroshi Ito, Yoshihisa Onodera, Kenichi Tajima, Koki Kikuchi |
1 . Complication of the shunt operation.
The complication contains various direct and prolonged effect, especially the subdural hematoma which is one of the direct effect is taken an interest. This mechanism was discussed on abrupt decreasing intraventricular pressure in procedure, using of the shunt valve without careful selection and others.
2 . Thichness of the cerebral mantle in neuroradiological stand.
In first examination, when the cerebral mantle of high pressure hydrocephalus is more than 2.5 cm. in the shunt operation, the functional prognosis was good in follow-up study.
3. Intraventricular fluid pressure (VFP).
Authors especially studied on C.S.F. pulse wave and mean pressure, and recognized the pattern of pulse wave is related remarkably to venous component.
This suspects the compensatory reservoire or decreasing ability of relative volume of venous system in the brain for increased intraventricular C.S.F. pressure. On the long term monitoring of VFP, three types including continuous high pressure, intermittent high pressure and continuous low pressure group were shown. The good effect of the shunt was justly in high pressure group.
4. Lead to rebleeding by the shunt operation of hydrocephalus after subarachnoidal hemorrhage.
The original of the bleeding are aneurysm and arteriovenous malformation mostly. The mechanism of rebleeding was discussed from the change of intracranial pressure and pressure gradient to aneurysml wall after the shunt operation. In addition, the subdural hematoma after the shunt operation was discussed in normal pressure hydrocephalus.
Key Words : Hydrocephalus, Shunt operation, Intraventricular C.S.F. pressure.
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