title: Low pressure hydrocephalus: clinical manifestations, radiological characteristics, and treatment.
abstract: Low pressure hydrocephalus (LPH) is a rare type of hydrocephalus with low intracranial pressure and ventriculomegaly. The recognition of LPH is important, and the treatment is difficult and very complicated. An understanding of how to drain cerebrospinal fluid when the intracranial pressure is lower than the opening pressure of the value represents a critical issue. Seven patients who suffered from the pain of hydrocephalus syndrome and were diagnosed with LPH were retrospectively reviewed. A ventricle peritoneal shunt was applied to all patients, and the valve system was adjusted to the lowest pressure; however, the clinical manifestations of hydrocephalus in five of seven patients did not improve over one week. Intermittent pressing of the valve in combination with the maintenance of a semi-reclined position were subsequently implemented. The symptoms of hydrocephalus began to improve from three days to two months following the initiation of intermittent valve pressing in combination with the maintenance of a semi-reclined position. At the twelve months follow up, six of seven patients (85.7%) showed good recovery to minimal disability. Intermittent valve pressing in combination with a semi-reclined position is an effective and easy method to drain cerebrospinal fluid when the intracranial pressure (ICP) is lower than the opening pressure of the value and improve hydrocephalus symptoms.
authors.affiliation: a Department of Neurosurgery , The First Affiliated Hospital of Soochow University , Suzhou , Jiangsu , China.|b Department of Neurosurgery , The Second Affiliated Hospital of Bengbu Medical college , Bengbu , Anhui , China.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Cheng
authors.affiliation: c Department of Neurosurgery , Traditional Chinese Medicine Hospital of Kunshan , Suzhou , Jiangsu , China.
authors.forename: Wenhua
authors.initials: W
authors.lastname: Wang
authors.affiliation: a Department of Neurosurgery , The First Affiliated Hospital of Soochow University , Suzhou , Jiangsu , China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Han
authors.affiliation: a Department of Neurosurgery , The First Affiliated Hospital of Soochow University , Suzhou , Jiangsu , China.
authors.forename: Jiangang
authors.initials: J
authors.lastname: Liu
authors.affiliation: a Department of Neurosurgery , The First Affiliated Hospital of Soochow University , Suzhou , Jiangsu , China.
authors.forename: Zhong
authors.initials: Z
authors.lastname: Wang
authors.affiliation: a Department of Neurosurgery , The First Affiliated Hospital of Soochow University , Suzhou , Jiangsu , China.
authors.forename: Youxin
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: d Department of Neurosurgery , Taizhou Second People's Hospital , Taizhou , Jiangsu , China.
authors.forename: Fengen
authors.initials: F
authors.lastname: Li
authors.affiliation: a Department of Neurosurgery , The First Affiliated Hospital of Soochow University , Suzhou , Jiangsu , China.
authors.forename: Yulun
authors.initials: Y
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D000328:Adult; D002557:Cerebrospinal Fluid Shunts; D002648:Child; D004322:Drainage; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D006849:Hydrocephalus / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D007427:Intracranial Pressure; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D056888:Patient Positioning; D011183:Postoperative Complications / Q000134:cerebrospinal fluid / Q000503:physiopathology; D012189:Retrospective Studies; D017287:Ventriculoperitoneal Shunt; D055815:Young Adult
keywords: Low pressure hydrocephalus; clinical manifestations; compliance; treatment