The Use of Q-Collar to Increase CSF Drainage in Low-pressure Hydrocephalus Patients

Study Overview
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Brief Summary
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The investigators hypothesize that the Q-collar compression on bilateral internal jugular veins of patients with low pressure hydrocephalus will decrease venous drainage from the intracranial space, therefore increasing intracranial volume, decreasing brain compliance, and increasing CSF drainage through the shunt. This should improve persistent hydrocephalus symptoms and demonstrate improved ventricular drainage on imaging with decompressed ventricles.

Detailed Description
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Low-pressure hydrocephalus is an entity that is rare and difficult to manage. At this institution, Dr. Paul Camarata uses a method of neck-wrapping in those low-pressure hydrocephalus patients that were admitted for complications with their shunt, hypothesized to decrease venous outflow from the intracranial space, increase venous pressure within the cranium and therefore increase the turgor in the brain tissue allowing for CSF to more easily be pushed out of the ventricular space and through the drain. This would relieve the hydrocephalus symptoms and reduce ventricular size on imaging. The advent of the Q-collar for reducing TBI in contact sports functions in a similar way to the neck-wrapping used at this institution, but via the simplified tool of the collar. It functions by compressing the internal jugular veins bilaterally to increase intracranial volume and prevent brain slosh that can occur in contact sports that leads to brain injury. The collar in contrast to the neck wrap occupies a smaller surface area, which the investigators hypothesize will reduce the discomfort that is commonly associated with neck wrap. Furthermore, applying this Q-collar to low pressure hydrocephalus patients that struggle with symptom management while inpatient, the investigators hypothesize that CSF drainage will improve with wearing the collar via increased intracranial volume and lower brain compliance, therefore improving persistent hydrocephalus symptoms that are limiting on patient quality of life.

Official Title
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The Use of Q-Collar to Increase CSF Drainage in Low-pressure Hydrocephalus Patients

Conditions
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Low Pressure Hydrocephalus

Intervention / Treatment
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* Device: Q-collar


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: adult with low-pressure hydrocephalus, able to cranial imaging, able to provide consent or have surrogate decision maker that is able to provide it for them Exclusion Criteria: pediatric patients, patients that can't consent or don't have a surrogate decision maker, patients that can't get cranial imaging

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Q-collar Intervention<br>All patients with low-pressure hydrocephalus that qualify for the study and agree to participate will receive the Q-collar for intervention | Device: Q-collar<br>* Q-collar is placed for all patients that are admitted with low-pressure hydrocephalus<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Ventricular drainage | Amount of ventricular drainage with Q collar treatment | within 4-6 weeks | 
| Ventricular size | change in ventricular size with Q collar treatment | within 4-6 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in low-pressure hydrocephalus symptoms | Patients surveyed daily regarding low-pressure hydrocephalus symptoms including headache, altered mental status, blurry vision, other. Will document if worse, unchanged, or improved. | 4-6 weeks |