{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T07:54:15Z","timestamp":1777622055921,"version":"3.51.4"},"reference-count":57,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2012,2]]},"abstract":"\nObject<\/jats:title>\nThe evaluation of third ventriculostomy function in hydrocephalic patients is challenging. The utility of the constant flow infusion test in predicting response to shunt insertion in normal-pressure hydrocephalus, as well as in identifying shunt malfunction, has been previously demonstrated. The object of this study was to evaluate its usefulness in determining whether a revision CSF diversion procedure was indicated in patients presenting with recurring symptoms and persisting ventriculomegaly after endoscopic third ventriculostomy (ETV).<\/jats:p><\/jats:sec>\n\nMethods<\/jats:title>\nThe authors conducted a prospective study of all patients who, after undergoing ETV at their institution, presented postoperatively with recurring symptoms and persisting ventriculomegaly.<\/jats:p><\/jats:sec>\n\nResults<\/jats:title>\nForty-six patients (mean age 40.7 years, including 11 patients younger than 18 years) underwent 56 constant flow ventricular infusion tests (VITs) at a mean of 24.7 months post-ETV. Thirty-three patients with resistance to CSF outflow (Rout<\/jats:sub>) less than 13 mm Hg\/ml\/min underwent follow-up (median 17 months) and experienced resolution of symptoms. In 10 episodes Rout<\/jats:sub> was greater than 13 mm Hg\/ml\/min; the patients in these cases underwent revisional CSF diversion. Two patients demonstrated high and frequent B (slow) waves despite a low Rout<\/jats:sub>; these patients also underwent successful revisions. Patients who improved after surgery had increased B wave activity in the plateau phase of the VIT (p = 0.01). Thirty-four patients underwent MR imaging at the same time; 4 had high Rout<\/jats:sub> despite evidence of flow across the stoma. These 4 patients underwent surgery and experienced resolution of symptoms. Of 9 patients without flow, Rout<\/jats:sub> was less than 13 mm Hg\/ml\/min in 4; these patients were successfully treated conservatively.<\/jats:p><\/jats:sec>\n\nConclusions<\/jats:title>\nThe VIT is a useful and safe adjunct to clinical and MR imaging evaluation when ETV failure is suspected.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2011.10.jns1140","type":"journal-article","created":{"date-parts":[[2011,11,18]],"date-time":"2011-11-18T14:53:13Z","timestamp":1321627993000},"page":"445-452","source":"Crossref","is-referenced-by-count":8,"title":["The constant flow ventricular infusion test: a simple and useful study in the diagnosis of third ventriculostomy failure"],"prefix":"10.3171","volume":"116","author":[{"given":"Kristian","family":"Aquilina","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian K.","family":"Pople","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenny","family":"Sacree","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael R.","family":"Carter","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard J.","family":"Edwards","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-jns1140","series-title":"J Neurosurg","first-page":"275","article-title":"Age dependency of resistance to cerebrospinal fluid outflow","volume":"89","author":"Albeck","year":"1998"},{"key":"b2-jns1140","series-title":"Neurosurgery","first-page":"91","article-title":"Routine placement of a ventricular reservoir at endoscopic third ventriculostomy","volume":"53","author":"Aquilina","year":"2003"},{"key":"b3-jns1140","series-title":"Childs Nerv Syst","first-page":"605","article-title":"Is the success rate of endoscopic third ventriculostomy age-dependent? An analysis of the results of endoscopic third ventriculostomy in young children","volume":"18","author":"Beems","year":"2002"},{"key":"b4-jns1140","series-title":"Clin Neurol Neurosurg","first-page":"223","article-title":"Intracranial pressure monitoring after endoscopic third ventriculostomy: an effective method to manage the \u2018adaptation period\u2019","volume":"103","author":"Bellotti","year":"2001"},{"key":"b5-jns1140","series-title":"Surg Neurol","first-page":"201","article-title":"The Dutch normal-pressure hydrocephalus study. How to select patients for shunting? An analysis of four diagnostic criteria","volume":"53","author":"Boon","year":"2000"},{"key":"b6-jns1140","series-title":"J Neurosurg","first-page":"687","article-title":"Dutch normal-pressure hydrocephalus study: prediction of outcome after shunting by resistance to outflow of cerebrospinal fluid","volume":"87","author":"Boon","year":"1997"},{"key":"b7-jns1140","series-title":"J Neurol Neurosurg Psychiatry","first-page":"385","article-title":"Changes in third ventricular size with neuroendoscopic third ventriculostomy: a blinded study","volume":"72","author":"Buxton","year":"2002"},{"key":"b8-jns1140","series-title":"J Neurosurg","first-page":"448","article-title":"Failure of third ventriculostomy in the treatment of aqueductal stenosis in children","volume":"90","author":"Cinalli","year":"1999"},{"issue":"4","key":"b9-jns1140","series-title":"Neurosurg Focus","first-page":"e3","article-title":"Failure of third ventriculostomy in the treatment of aqueductal stenosis in children","volume":"6","author":"Cinalli","year":"1999"},{"key":"b10-jns1140","series-title":"Neurosurgery","first-page":"126","article-title":"Intracranial pressure monitoring and lumbar puncture after endoscopic third ventriculostomy in children","volume":"58","author":"Cinalli","year":"2006"},{"key":"b11-jns1140","series-title":"Physiol Meas","first-page":"R51","article-title":"Cerebrospinal fluid dynamics","volume":"25","author":"Czosnyka","year":"2004"},{"key":"b12-jns1140","series-title":"J Neurosurg","first-page":"482","article-title":"Age dependence of cerebrospinal pressure-volume compensation in patients with hydrocephalus","volume":"94","author":"Czosnyka","year":"2001"},{"key":"b13-jns1140","series-title":"J Neurol Neurosurg Psychiatry","first-page":"549","article-title":"Testing of cerebrospinal compensatory reserve in shunted and non-shunted patients: a guide to interpretation based on an observational study","volume":"60","author":"Czosnyka","year":"1996"},{"key":"b14-jns1140","series-title":"Can J Neurol Sci","first-page":"643","article-title":"Cine phase-contrast MR images failed to predict clinical outcome following ETV","volume":"36","author":"Di","year":"2009"},{"issue":"2 Suppl","key":"b15-jns1140","series-title":"J Neurosurg","first-page":"118","article-title":"Late rapid deterioration after endoscopic third ventriculostomy: additional cases and review of the literature","volume":"105","author":"Drake","year":"2006"},{"key":"b16-jns1140","series-title":"Surg Neurol","first-page":"5","article-title":"Success and complication rates of endoscopic third ventriculostomy for adult hydrocephalus: a series of 108 patients","volume":"69","author":"Dusick","year":"2008"},{"key":"b17-jns1140","series-title":"Neurosurgery","first-page":"1425","article-title":"Telemetric intraventricular pressure measurements after third ventriculocisternostomy in a patient with noncommunicating hydrocephalus","volume":"41","author":"Frim","year":"1997"},{"key":"b18-jns1140","series-title":"Neurosurgery","first-page":"1100","article-title":"Risk factors for failure of endoscopic third ventriculostomy for obstructive hydrocephalus","volume":"46","author":"Fukuhara","year":"2000"},{"key":"b19-jns1140","series-title":"AJNR Am J Neuroradiol","first-page":"1560","article-title":"Third ventriculostomy patency: comparison of findings at cine phasecontrast MR imaging and at direct exploration","volume":"20","author":"Fukuhara","year":"1999"},{"key":"b20-jns1140","series-title":"Minim Invasive Neurosurg","first-page":"128","article-title":"Endoscopic third ventriculostomy for hydrocephalus","volume":"42","author":"Gangemi","year":"1999"},{"key":"b21-jns1140","series-title":"Neurosurgery","first-page":"129","article-title":"Endoscopic third ventriculostomy in idiopathic normal pressure hydrocephalus","volume":"55","author":"Gangemi","year":"2004"},{"issue":"4","key":"b22-jns1140","series-title":"Neurosurg Focus","first-page":"E10","article-title":"Continuous intracranial pressure monitoring via the shunt reservoir to assess suspected shunt malfunction in adults with hydrocephalus","volume":"22","author":"Geocadin","year":"2007"},{"key":"b23-jns1140","series-title":"Pediatr Neurosurg","first-page":"149","article-title":"Treatment of hydrocephalus with third ventriculocisternostomy: outcome and CSF flow patterns","volume":"27","author":"Goumnerova","year":"1997"},{"key":"b24-jns1140","series-title":"J Neurosurg Pediatr","first-page":"298","article-title":"Intraoperative assessment of endoscopic third ventriculostomy success. 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