Turkish Neurosurgery
Cerebral blood perfusion is improved regionally after shunt surgery in the high-pressure hydrocephalic brain
Jiang Ying 1, Wu Xiao-Jun 2, Shi Xiao-Lei 3, Fan Rong-Rong 3, Chen Wen 1, Zhang Teng-Fei 1, Huang Chen-Guang 1, Hou Li-Jun 1
1Shanghai Changzheng Hospital, Department of Neurosurgery, Shanghai,
2Shanghai Cancer Center, Shanghai Fu-Dan University School of Medicine, Department of Neurosurgery, Shanghai,
3Shanghai Changzheng Hospital, 3. Department of Radiology, Shanghai,
DOI: 10.5137/1019-5149.JTN.38500-22.2
Aim:Cerebral blood perfusion is improved regionally after shunt surgery in the high-pressure hydrocephalic brainMaterial and Methods:One-hundred-and-four patients, with high-pressure hydrocephalus (spinal tap opening pressure > 180 mmH2O), were prospectively enrolled in our study. The computed tomography perfusion (CTP) was scheduled for 7-10 days pre- and post-shunt surgery. The TMT and Glasgow Coma Scale (GCS) scores were collected during the same session. Results:The CTP after the shunt surgery revealed a significant increase in cerebral blood volume (CBV) in both hemispheres (P<0.05). More specifically, this CBV increase was observed in the midbrain, cerebellum, basal ganglion, temporal lobe, and frontal lobe regions (all P<0.05). Simultaneously, patients’ post-surgical TMT and GCS scores also increased compared to their pre-surgical scores since the first post-shunt follow-up (P<0.01). Notably, while the GCS scores continued to increase during the post-shunt follow-up, the TMT exhibited a fluctuation period after the shunt and required seven days to reach a steady state. Conclusion:Our study revealed that a shunt could significantly increase cerebral perfusion in high-pressure hydrocephalic patients in a region-specific manner. During the perioperative period of hydrocephalus, TMT can be used to monitor cerebral hemodynamic changes.
Corresponding author : Jiang Ying