Diagnosis and treatment of low pressure hydrocephalus: report of 5 cases

Abstract

Objective To explore the clinical symptoms, diagnosis and treatment of low intracranial pressure hydrocephalus (LPH). Methods The ventriculo-peritoneal shunt (VPS) with pressure-adjustable valves was performed in 5 patients with low intracranial pressure hydrocephalus in Nantong First People’s Hospital from October 2012 to December 2015. The diagnosis of LPH in 2 patients was definitely made by lumbar puncture drainage before VPS. LPH developed during the following-up during which the patients’ symptoms were not improved untile the drainage under the negative pressure in 3 patients with normal pressure hydrocephalus. Results The following-up from 2 to 28 months after VPS showed that the clinical symptoms were improved and the enlarged ventricles significantly retracted in all patients. Conclusion LPH is uncommon and occultly comes on. LPH is similar to normal pressure hydrocephalus in the clinical manifestation. CT and MRI show that there are ventriculomegaly in all the patients with LPH and periventricular edema in some patients with LPH. VPS with pressure-adjustable valve is an effective method to treat LPH. The perfect threshold value of pressure adjustable valves, which is suitable for the individual, may be got by more than once adjustment and long-term observation of the curative effect. Key words: Low intracranial pressure hydrocephalus; Pressure-adjustable valve; Ventriculo-peritoneal shunt