Review of the lumbar infusion test use in pediatric populations: state-of-the-art and future perspectives
Abstract Background The lumbar infusion test (LIT) is a routine part of the diagnostic process of various CSF dynamics disorders in adults. However, it is rarely used in the paediatric population due to a lack of evidence substantiating its efficacy and overall indications. Methods Articles utilizin...
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BMC
2025-05-01
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| Series: | Fluids and Barriers of the CNS |
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| Online Access: | https://doi.org/10.1186/s12987-025-00662-9 |
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| author | Vojtěch Novák Adéla Bubeníková Petr Skalický Arnošt Mládek Václav Gerla Afroditi Despina Lalou Aleš Vlasák Róbert Leško Ondřej Bradáč |
| author_facet | Vojtěch Novák Adéla Bubeníková Petr Skalický Arnošt Mládek Václav Gerla Afroditi Despina Lalou Aleš Vlasák Róbert Leško Ondřej Bradáč |
| author_sort | Vojtěch Novák |
| collection | DOAJ |
| description | Abstract Background The lumbar infusion test (LIT) is a routine part of the diagnostic process of various CSF dynamics disorders in adults. However, it is rarely used in the paediatric population due to a lack of evidence substantiating its efficacy and overall indications. Methods Articles utilizing the LIT in a paediatric cohort (≤ 18 years) were included according to the PRISMA guidelines with the Newcastle-Ottawa Scale to assess the risk of bias. This review was registered at PROSPERO database under number: CRD42024625857. Results A total of 15 studies, yielding 441 patients, were included in the review. The most common indications for LIT were to predict shunt responsiveness in hydrocephalus and idiopathic intracranial hypertension (IIH). In IIH, the interaction between cerebrospinal fluid pressure (CSFp) and sagittal sinus pressure (SSp) may offer valuable diagnostic insights and present a novel assessment approach. The LIT is a validated tool, especially effective for predicting shunt responsiveness and detecting malfunctions in both IIH and hydrocephalus. Conclusions Data surrounding LIT usage in children is lacking and most studies are outdated. Caution is needed when interpreting resistance to outflow (Rout) due to potential overestimation, with more attention directed to CSFp and the pressure within the venous system coupling in IIH. Future studies should focus on standardizing LIT protocols across age groups with focusing more on signal characteristics rather than individual parameters and fostering interdisciplinary collaboration to optimize diagnostic accuracy. |
| format | Article |
| id | doaj-art-29afe0d763e84d7d9d326a7d7c527ebe |
| institution | OA Journals |
| issn | 2045-8118 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Fluids and Barriers of the CNS |
| spelling | doaj-art-29afe0d763e84d7d9d326a7d7c527ebe2025-08-20T02:25:16ZengBMCFluids and Barriers of the CNS2045-81182025-05-0122111210.1186/s12987-025-00662-9Review of the lumbar infusion test use in pediatric populations: state-of-the-art and future perspectivesVojtěch Novák0Adéla Bubeníková1Petr Skalický2Arnošt Mládek3Václav Gerla4Afroditi Despina Lalou5Aleš Vlasák6Róbert Leško7Ondřej Bradáč8Department of Neurosurgery, Second Faculty of Medicine, Charles University and Motol University HospitalDepartment of Neurosurgery, Second Faculty of Medicine, Charles University and Motol University HospitalDepartment of Neurosurgery, Second Faculty of Medicine, Charles University and Motol University HospitalDepartment of Cognitive Systems and Neurosciences, Robotics and Cybernetics, Czech Institute of Informatics, Czech Technical UniversityDepartment of Cognitive Systems and Neurosciences, Robotics and Cybernetics, Czech Institute of Informatics, Czech Technical UniversityDepartment of Clinical Neurosciences, Division of Neurosurgery, Brain Physics Laboratory, University of Cambridge & Cambridge University Hospital NHS Foundation TrustDepartment of Neurosurgery, Second Faculty of Medicine, Charles University and Motol University HospitalDepartment of Neurosurgery, Second Faculty of Medicine, Charles University and Motol University HospitalDepartment of Neurosurgery, Second Faculty of Medicine, Charles University and Motol University HospitalAbstract Background The lumbar infusion test (LIT) is a routine part of the diagnostic process of various CSF dynamics disorders in adults. However, it is rarely used in the paediatric population due to a lack of evidence substantiating its efficacy and overall indications. Methods Articles utilizing the LIT in a paediatric cohort (≤ 18 years) were included according to the PRISMA guidelines with the Newcastle-Ottawa Scale to assess the risk of bias. This review was registered at PROSPERO database under number: CRD42024625857. Results A total of 15 studies, yielding 441 patients, were included in the review. The most common indications for LIT were to predict shunt responsiveness in hydrocephalus and idiopathic intracranial hypertension (IIH). In IIH, the interaction between cerebrospinal fluid pressure (CSFp) and sagittal sinus pressure (SSp) may offer valuable diagnostic insights and present a novel assessment approach. The LIT is a validated tool, especially effective for predicting shunt responsiveness and detecting malfunctions in both IIH and hydrocephalus. Conclusions Data surrounding LIT usage in children is lacking and most studies are outdated. Caution is needed when interpreting resistance to outflow (Rout) due to potential overestimation, with more attention directed to CSFp and the pressure within the venous system coupling in IIH. Future studies should focus on standardizing LIT protocols across age groups with focusing more on signal characteristics rather than individual parameters and fostering interdisciplinary collaboration to optimize diagnostic accuracy.https://doi.org/10.1186/s12987-025-00662-9Lumbar infusion testInfusion testingIntracranial hypertensionHydrocephalusPediatricChildren |
| spellingShingle | Vojtěch Novák Adéla Bubeníková Petr Skalický Arnošt Mládek Václav Gerla Afroditi Despina Lalou Aleš Vlasák Róbert Leško Ondřej Bradáč Review of the lumbar infusion test use in pediatric populations: state-of-the-art and future perspectives Fluids and Barriers of the CNS Lumbar infusion test Infusion testing Intracranial hypertension Hydrocephalus Pediatric Children |
| title | Review of the lumbar infusion test use in pediatric populations: state-of-the-art and future perspectives |
| title_full | Review of the lumbar infusion test use in pediatric populations: state-of-the-art and future perspectives |
| title_fullStr | Review of the lumbar infusion test use in pediatric populations: state-of-the-art and future perspectives |
| title_full_unstemmed | Review of the lumbar infusion test use in pediatric populations: state-of-the-art and future perspectives |
| title_short | Review of the lumbar infusion test use in pediatric populations: state-of-the-art and future perspectives |
| title_sort | review of the lumbar infusion test use in pediatric populations state of the art and future perspectives |
| topic | Lumbar infusion test Infusion testing Intracranial hypertension Hydrocephalus Pediatric Children |
| url | https://doi.org/10.1186/s12987-025-00662-9 |
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