Combined Flow and Pressure Study of Craniospinal Dynamic

Summary

Normal pressure hydrocephalus (NPH) can cause a type of dementia. However, this type of dementia is the only one that is reversible. To treat this dementia it is necessary to evacuate the accumulation of CSF from the brain to another body cavity using a device called a shunt. But the implantation of this shunt is only effective when the cause of the pathology is an alteration of the normal circulation of the CSF. To diagnose these patients, morphological MRI and lumbar puncture are standard approaches used but remain perfectible in diagnostic terms.

The main objective is to build a new model of the interaction of intracranial pressures and fluids in order to obtain a new parameter allowing to obtain information on the cerebral biomechanics.

Conditions

• Intracranial Pressure
• Cerebral Blood Flows
• Infusion Test
• Phase Contrast MRI
• Hydrocephalus
• Dementia

Interventions

OTHER

Flow MRI

4 flow acquisitions based on the 2D cine phase contrast sequence (present on all MRI systems) will be performed. This sequence requires a cardiac synchronization by a plethysmograph put on the patient's finger. 32 cardiac phases are reconstructed per acquisition. The processing of the flow MRIs and the analysis of the flow curves of the LCS and blood during the cardiac cycle will be performed using the Amiens software. Parameters measured via flow MRI are: \- Cerebral vascular flow, intracranial LCS dynamic volume, extracranial LCS dynamic volume

OTHER

PERFUSION TEST

The test will be performed will include: * Inserting a needle into the lumbar space, Ommaya reservoir or valve pre-chamber, as appropriate * Connect the needle to the pressure transducer via saline filled manometer lines connected via a 3-way valve. The other end of the 3-way connection will be connected to a saline * Recording of the opening pressure for 10 minutes * The infusion test is terminated either when the pressure stabilizes again on a new plateau, or when the average pressure exceeds 40 mmHg, or in case of adverse effects or symptoms such as headache, nausea/vomiting or visual disturbances. * At the end of the test, a depletion of 30 to 50 mL of CSF will be performed. * The pressure recording during the test is then used to calculate the parameters of the mechanical properties of the CSF circulation and reported to the neurosurgeon ordering the test.

Sponsors & Collaborators

• University Hospital, Caen

  collaborator OTHER

• University Hospital, Brest

  collaborator OTHER

• Centre Hospitalier Universitaire, Amiens

  lead OTHER

Eligibility

Min Age

55 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2021-09-01

Primary Completion

2023-09-01

Completion

2024-09-30

Countries

• France

Study Locations