1998 Fiscal Year Final Research Report Summary
Basic and Clinical Study of Morphological and Functional Changes in Brainstem and Cerebellum in the Cases with Disturbances in Dynamics of Cerebrospinal Fluid Circulation
| Project/Area Number |
08457365
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| Research Category |
Grant-in-Aid for Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Cerebral neurosurgery
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| Research Institution | Kobe University |
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Principal Investigator |
TAMAKI Norihiko Kobe University School of Medicine, Department of Neurosurgery, professor, 医学部, 教授 (10030941)
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| Co-Investigator(Kenkyū-buntansha) |
EHARA Kazumasa Kobe University School of Medicine, Department of Neurosurgery, assistant profes, 医学部, 助教授 (20151996)
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| Project Period (FY) |
1996 – 1998
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| Keywords | NPH / circulation of CSF / function of brain stem and cerebellum / MRI / ventriculomegaly / ventriculo-peritoneal shunt / cerebral blood flow |
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| Research Abstract |
Perioperatively intelligence tests were performed in fourteen cases (mean age of 74.8 years) that were diagnosed normal pressure hydrocephalus. Criteria for shunts were, 1) mar than two of trias of NPH, 2) ventriculomegaly, 3) IIIb-V in CTC, 4) rate of B-wave was more than 35% in ICP monitoring, 5) not high risk of operation and general anesthesia. All cases were performed shunts. Surgical results of intelligence tests were good in four cases, fair in four cases, no change in four cases and deteriorated in two cases.
CT, MRI, CT cisternography, and cerebral blood flow measurement were analyzed in seven cases (mean age of 66 years) of normal pressure hydrocephaly. V-P shunts were performed in all ases. Postopretave symptoms were improved in five cases. There were tendencies of improvement after sugical treatments in cases which had severe ventriculomegaly, low CBF in periventricular white matter and cortex of frontal lobe, and higher frequency of abnormal waves in ICP monitoring.
We performed a retrospective study in 124 patients (mean age of 35.5 years) of hydrocephalus. Forty-five patients were performed only single shunt operations. Forty-nine patients required the revisions of their shunts. The postoperative symtopms were improved in some cases even if they didn't fill the criteria of CTC or ICP monitoring test. Further investigation is required in analyzing clinical symptom with cerebrospinal fluid dynamic test in decision making for shunt operation.
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