Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Resistance to Cerebrospinal Fluid Outflow Measured by Bolus Injection Method in Normal Adults

Bolus Injection 방법을 이용해서 측정한 정상 성인의 뇌척수액 배출저항

  • Kim, Eun-Young (Department of Neurosurgery, Inha University Hospital, College of Medicine, Inha University) ;
  • Park, Hyun Sun (Department of Neurosurgery, Inha University Hospital, College of Medicine, Inha University) ;
  • Chung, Chong Kweon (Department of Anesthesiology, Inha University Hospital, College of Medicine, Inha University) ;
  • Jin, Tae Kyoung (Department of Neurosurgery, Inha University Hospital, College of Medicine, Inha University) ;
  • Kim, Jae Joong (Department of Neurosurgery, Inha University Hospital, College of Medicine, Inha University) ;
  • Park, Hyung Chun (Department of Neurosurgery, Inha University Hospital, College of Medicine, Inha University)
  • 김은영 (인하대학교 의과대학 인하대학병원 신경외과학교실) ;
  • 박현선 (인하대학교 의과대학 인하대학병원 신경외과학교실) ;
  • 정종권 (인하대학교 의과대학 인하대학병원 마취과) ;
  • 진태경 (인하대학교 의과대학 인하대학병원 신경외과학교실) ;
  • 김재중 (인하대학교 의과대학 인하대학병원 신경외과학교실) ;
  • 박형천 (인하대학교 의과대학 인하대학병원 신경외과학교실)
  • Received : 2000.02.07
  • Accepted : 2000.06.29
  • Published : 2000.09.28
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Abstract

Objectives : The measurement of resistance to cerebrospinal fluid outflow($R_o$) can clearly delineate cerebrospinal fluid dynamics in patients with ventricular dilatation and can help in selecting patients to undergo shunt placement. With regards to type of infusion method, bolus injection is known to be more practical and safer than continuous infusion. The purpose of this study was to obtain $R_o$ of normal adults using lumbar bolus injection method. Material and Methods : Twenty adults aged 25 to 52 years were studied using lumbar bolus injection method. Fifteen patients with hemifacial spasm and five with cerebral concussion underwent $R_o$ measurement under propofol general anesthesia and local anesthesia, respectively. Results : The mean values of $R_o$ determined 1 minute and 2 minutes after bolus injection were $4.8{\pm}1.7$ and $4.4{\pm}1.6mmHg/ml/min$, respectively. There was no significant difference of $R_o$ between propofol general anesthesia group and local anesthesia group. Two patients showed $R_o$ greater than 6mmHg/ml/min. One patient revealed unexpectedly high level of $R_o$ due to severe spinal stenosis. Conclusion : Mean Ro in this study was higher than that of Shapiro's study. Borderline Ro near 6mmHg/ml/min should be regarded with caution and compared with clinical symptoms and results of other studies. Patients with severe spinal stenosis should be evaluated with caution.

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