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Croatian Medical Journal, Vol. 57 No. 3, 2016.

Original scientific paper

https://doi.org/10.3325/cmj.2016.57.293

The effects of lumboperitoneal and ventriculoperitoneal shunts on the cranial and spinal cerebrospinal fluid volume in a patient with idiopathic intracranial hypertension

Ines Nikić ; Croatian Institute for Brain Research, Zagreb University Schoolof Medicine, Zagreb, Croatia
Milan Radoš ; Croatian Institute for Brain Research, Zagreb University Schoolof Medicine, Zagreb, Croatia
Ana Frobe ; Department of Oncology and Nuclear Medicine, Clinical HospitalCenter “Sestre Milosrdnice,” Zagreb, Croatia
Miroslav Vukić ; Department of Neurosurgery Clinical Hospital Center Zagreb, Zagreb, Croatia
Darko Orešković ; Department of Molecular Biology, Ruđer Bošković Institute, Zagreb, Croatia
Marijan Klarica ; Croatian Institute for Brain Research, Zagreb University Schoolof Medicine, Zagreb, Croatia

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Abstract

Lumboperitoneal (LP) and ventriculoperitoneal (VP) shunts
are a frequent treatment modality for idiopathic intracranial
hypertension (IIH). Although these shunts have been
used for a long time, it is still not clear how they change
the total craniospinal CSF volume and what portions of
cranial and spinal CSF are affected. This report for the first
time presents the results of a volumetric analysis of the total
cranial and spinal CSF space in a patient with IIH. We
performed an automated segmentation of the cranial and
a manual segmentation of the spinal CSF space first with
an LP shunt installed and again after the LP shunt was replaced
by a VP shunt. When the LP shunt was in place, the
total CSF volume was smaller than when the VP shunt was
in place (222.4 cm3 vs 279.2 cm3). The difference was almost
completely the result of the spinal CSF volume reduction
(49.3 cm3 and 104.9 cm3 for LP and VP, respectively), while
the cranial CSF volume was not considerably altered (173.2
cm3 and 174.2 cm3 for LP and VP, respectively). This report
indicates that LP and VP shunts in IIH do not considerably
change the cranial CSF volume, while the reduction of CSF
volume after LP shunt placement affects almost exclusively
the spinal part of the CSF system. Our results suggest that
an analysis of both the cranial and the spinal part of the
CSF space is necessary for therapeutic procedures planning
and for an early recognition of numerous side effects
that often arise after shunts placement in IIH patients.

Keywords

Hrčak ID:

170171

URI

https://hrcak.srce.hr/170171

Publication date:

15.6.2016.

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