Diagnosis of hydrocephalus by CSF pulse-wave analysis: a clinical study

Pulsatility of the cerebrospinal fluid (CSF) is augmented in hydrocephalus. Analysis of pulsatility, including the CSF waveform, may be a more valid criterion for the diagnosis of hydrocephalus than mean CSF pressure. To test this possibility, CSF pressures were measured in 118 patients with presumed hydrocephalus. The pressure measurements included baseline mean pressure and pulse pressure, responses to jugular compression, and CSF wave analysis (amplitude and peak latency). Four groups of pressure recordings were identified and matched with four clinical groups: normal, arrested hydrocephalus, communicating hydrocephalus, and aqueduct stenosis hydrocephalus. The CSF pulse pressure and systolic slope form were highly reliable in the diagnosis of hydrocephalus, whereas mean CSF pressure was not reliable.