Vascular endothelial growth factor in the CSF of elderly patients with ventriculomegaly: Variability, periodicity and levels in drainage responders and non-responders

Jun Yang, Stephen M. Dombrowski, Chandra Krishnan, Natalie Krajcir, Abhishek Deshpande, Serge El-Khoury, Deepti Kamasamudram Guruprakash, Mark G. Luciano

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives The aim of this study was to examine lumbar CSF-VEGF levels from elderly patients with ventriculomegaly to evaluate the possible circadian or periodic concentration profile and relevance to the prediction of drainage response. Methods Lumbar CSF samples were collected in 1-h interval over 35 h from 22 patients with ventriculomegaly. CSF-VEGF levels were measured to elucidate the possible circadian or periodic concentration profiles. These VEGF levels were evaluated for correlations with clinical response to CSF drainage, ventricle size and other clinical information. Results The 35-h CSF-VEGF levels demonstrated a periodic concentration pattern with significant episodic fluctuation with 3-5 h intervals. CSF-VEGF levels in non-responder group in which patients did not show clinical improvement with CSF drainage were significantly higher than these in responder group. Conclusion VEGF variation in hydrocephalus patients suggests its possible pathophysiological role in hydrocephalus. The periodic concentration pattern of CSF-VEGF must be considered when choosing the most appropriate time for sample collection or clinical manipulation. Increased VEGF level in patients who showed no improvement with CSF drainage suggests that a possible greater ischemic or vascular injury may play a role in these patients. Pending further studies, these results suggest that high VEGF levels have a potential application in predicting non-responder patients with CSF drainage and so reducing the morbidity and cost of drainage and shunting in these patients.

Original languageEnglish (US)
Pages (from-to)1729-1734
Number of pages6
JournalClinical Neurology and Neurosurgery
Volume115
Issue number9
DOIs
StatePublished - Sep 1 2013
Externally publishedYes

Keywords

  • Circadian
  • Concentration
  • Continuous CSF sampling
  • Periodic
  • VEGF

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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