Related Experiment Video
Updated: Jun 19, 2026

Modeling Posthemorrhagic Hydrocephalus of Prematurity in Rats
Published on: March 28, 2025
Clinical proof of the importance of compliance for hydrocephalus pathophysiology
Michael Kiefer1, Regina Eymann
1Department of Neurosurgery, Saarland University Medical School, Homburg-Saar, Germany. Michael.Kiefer@uks.eu
Introduction:
Recently decreased compliance is discussed as an initially disturbed CSF hydrodynamic parameter in hydrocephalus.
Materials And Methods:
In 180 patients with suspected chronic hydrocephalus we performed a dynamic infusion test, which was not used for shunt indication. Shunt indication was based on long-term ICP monitoring. Follow-up was 4.6 +/- 1.8 years.
Statistics:
Spearman-, Kruskal-Wallis-, Wilcoxen-U-test.
Results:
Resistance to outflow (Rout) and Pressure Volume Index (PVI) alone provide positive predictive values (PPV) and sensitivity, which might be sufficient in daily practice, while negative predictive values (NPV) and specificity are weak. With an intelligent combined algorithm of Rout and PVI at a critical value of ROF of 13 mm Hg/ml x min and 30 ml, a clearly improved outcome prediction is possible.
Conclusion:
These clinical results support recent opinions concerning the meaning of Compliance and Rout in hydrocephalus patho-physiology.
Related Concept Videos
Increased Intracranial Pressure ll: Pathophysiology
Cerebral Edema ll: Pathophysiology
Increased Intracranial Pressure l: Introduction
Cerebral Edema l: Introduction
Cerebrospinal Fluid
CSF Production
CSF is produced mainly in the choroid plexus, a network of capillaries and ependymal cells located within the ventricular system of the brain.
Cytotoxic Edema: Pathophysiology
