title: Negative-Pressure Hydrocephalus: A Case Report on Successful Treatment Under Intracranial Pressure Monitoring with Bilateral Ventriculoperitoneal Shunts.
abstract: BACKGROUND
  Negative-pressure hydrocephalus (NegPH), a very rare condition of unknown etiology and optimal treatment, usually presents postneurosurgery with clinical and imaging features of hydrocephalus, but with negative cerebrospinal fluid pressure.
  
  
  METHODS
  We describe a NegPH case of -3 mm Hg intracranial pressure that was successfully treated to achieve 5 mm Hg under continuous intracranial pressure monitoring with horizontal positioning, head down and legs elevated to 10°-15°, neck wrapping for controlled venous drainage, chest and abdomen bandages, infusion of 5% dextrose fluid to lower plasma osmolarity (Na+, 130-135 mmol/L), daily cerebrospinal fluid drainage >200 mL, and arterial blood gas partial pressure of carbon dioxide >40 mm Hg.
authors.affiliation: Department of Neurosurgery, Shanghai 10th affiliated hospital of Tongji University, Shanghai, P.R. China.
authors.forename: Sajan
authors.initials: S
authors.lastname: Pandey
authors.affiliation: Department of Neurosurgery, Shanghai 10th affiliated hospital of Tongji University, Shanghai, P.R. China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Jin
authors.affiliation: Department of Neurosurgery, Shanghai 10th affiliated hospital of Tongji University, Shanghai, P.R. China.
authors.forename: Liang
authors.initials: L
authors.lastname: Gao
authors.affiliation: Department of Neurosurgery, Shanghai 10th affiliated hospital of Tongji University, Shanghai, P.R. China.
authors.forename: Cheng Cheng
authors.initials: CC
authors.lastname: Zhou
authors.affiliation: Department of Neurosurgery, Shanghai 10th affiliated hospital of Tongji University, Shanghai, P.R. China. Electronic address: 2177410002@qq.com.
authors.forename: Da Ming
authors.initials: DM
authors.lastname: Cui
mesh_terms: D000328:Adult; D001458:Bandages; D002557:Cerebrospinal Fluid Shunts; D003388:Cranial Fossa, Posterior; D004322:Drainage; D004814:Epidermal Cyst / Q000000981:diagnostic imaging / Q000601:surgery*; D005947:Glucose / Q000627:therapeutic use*; D006801:Humans; D006849:Hydrocephalus / Q000150:complications / Q000628:therapy*; D019585:Intracranial Hypotension / Q000150:complications / Q000628:therapy*; D007427:Intracranial Pressure; D008279:Magnetic Resonance Imaging; D008297:Male; D008991:Monitoring, Physiologic; D009994:Osmolar Concentration; D056888:Patient Positioning / Q000379:methods*; D017287:Ventriculoperitoneal Shunt
chemical_list: D005947:Glucose
keywords: Low-pressure hydrocephalus; Titrated CSF drainage; Treatment of negative-pressure hydrocephalus; Very low–pressure hydrocephalus