Turkish Neurosurgery 2024 , Vol 34 , Num 1
Cerebral Blood Perfusion is Improved Regionally After Shunt Surgery in the High-Pressure Hydrocephalic Brain
Ying JIANG1,Wei Huang2,Xiao-Jun Wu3
1Shanghai Jiao Tong University School of Medicine, Renji Hospital, Cerebrovascular Diseases Center, Department of Neurosurgery, Shanghai, PR China
2The First Affiliated Hospital of Kunming Medical University, Department of Minimally Invasive Neurosurgery, Kunming, Yunnan, PR China
3Shanghai Fu-Dan University School of Medicine, Shanghai Cancer Center, Department of Neurosurgery, Shanghai, PR China
DOI : 10.5137/1019-5149.JTN.38500-22.2 AIM: To show the abnormal cerebral hemodynamics, in high-pressure hydrocephalic patients, could be restored by shunt surgery, and the tympanic membrane temperature (TMT) could be used to non-invasively monitor this recovery process.

MATERIAL 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 preand 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. Keywords : Cerebral blood, Hydrocephalus, Ventriculoperitoneal shunt, Perfusion, Temperature, Tympanic membrane

Corresponding author : Ying JIANG, yjiang1@vt.edu