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Objective B wave analysis in 55 patients with non-communicating and communicating hydrocephalus
H Stephensen1, N Andersson, A Eklund
1Hydrocephalus Research Unit, Institute of Clinical Neuroscience, Sahlgrenska University Hospital, Göteborg University, 413 45 Göteborg, Sweden.
Journal of Neurology, Neurosurgery, and Psychiatry
|June 21, 2005
Summary
B waves, oscillations in intracranial pressure, are not strong predictors of surgical outcomes in hydrocephalus patients. A weak correlation exists between B waves during sleep and postsurgical improvement.
Area of Science:
- Neurosurgery
- Neurology
- Medical Technology
Background:
- B waves, characterized by slow, rhythmic intracranial pressure (ICP) oscillations, are considered potential predictors of surgical outcomes in normal pressure hydrocephalus (NPH).
- Understanding the role of B waves in hydrocephalus management is crucial for improving patient prognoses.
Purpose of the Study:
- To investigate the relationship between the percentage of B waves and patient outcomes following hydrocephalus surgery.
- To examine the diurnal variations in B wave activity.
Main Methods:
- Intracranial pressure (ICP) and patient behavior were monitored overnight in 55 patients (29 non-communicating hydrocephalus, 26 NPH).
- B wave activity was quantified as the percentage of total monitoring time (% B waves) using a computer algorithm across various amplitude thresholds.
- Postoperative outcomes were assessed by changes in 12 standardized symptoms and signs.
Main Results:
- No linear correlation was found between overall % B waves and postsurgical improvement in the 55 patients.
- A significant correlation (r = 0.39, p = 0.04) was observed between improvement and % B waves specifically during sleep.
- B wave percentages did not differ significantly between sleep and wakefulness, nor between NPH and non-communicating hydrocephalus groups.
Conclusions:
- B waves are prevalent in both communicating and non-communicating hydrocephalus.
- The predictive value of B waves for postsurgical improvement in hydrocephalus is limited, with only a weak association observed.