Objective B wave analysis in 55 patients with non-communicating and communicating hydrocephalus
H Stephensen, N Andersson, A Eklund… - Journal of Neurology …, 2005 - jnnp.bmj.com
H Stephensen, N Andersson, A Eklund, J Malm, M Tisell, C Wikkelsö
Journal of Neurology, Neurosurgery & Psychiatry, 2005•jnnp.bmj.comBackground: B waves, slow and rhythmic oscillations in intracranial pressure (ICP), are
claimed to be one of the best predictors of outcome after surgery for normal pressure
hydrocephalus (NPH). Object: To determine the relation between the percentage of B waves
and outcome in patients with hydrocephalus, and also the diurnal variation of B waves.
Methods: ICP and patient behaviour were recorded overnight (17 to 26 hours) in 29 patients
with non-communicating hydrocephalus and 26 with NPH. The B wave activity, measured …
claimed to be one of the best predictors of outcome after surgery for normal pressure
hydrocephalus (NPH). Object: To determine the relation between the percentage of B waves
and outcome in patients with hydrocephalus, and also the diurnal variation of B waves.
Methods: ICP and patient behaviour were recorded overnight (17 to 26 hours) in 29 patients
with non-communicating hydrocephalus and 26 with NPH. The B wave activity, measured …
Background: B waves, slow and rhythmic oscillations in intracranial pressure (ICP), are claimed to be one of the best predictors of outcome after surgery for normal pressure hydrocephalus (NPH).
Object: To determine the relation between the percentage of B waves and outcome in patients with hydrocephalus, and also the diurnal variation of B waves.
Methods: ICP and patient behaviour were recorded overnight (17 to 26 hours) in 29 patients with non-communicating hydrocephalus and 26 with NPH. The B wave activity, measured with an amplitude threshold of 0.5, 0.75, 1.0, 1.5, 2.0, 3.0, and 5.0 mm Hg, was estimated as the percentage of total monitoring time (% B waves) using a computer algorithm, and correlated with postoperative outcome, defined as changes in 12 standardised symptoms and signs.
Results: There was no linear correlation between improvement after surgery in the 55 patients and total % B waves, but a correlation was found between improvement and % B waves during sleep (r = 0.39, p = 0.04). The percentage of B waves was the same during sleep and wakefulness, and patients with NPH had the same proportion of B waves as the non-communicating patients.
Conclusions: B waves are commonly observed in patients with both communicating and non-communicating hydrocephalus, but are only weakly related to the degree of postsurgical improvement.
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