Comparative investigation of different telemetric methods for measuring intracranial pressure: a prospective pilot study

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Objectives

Measurement of intracranial pressure (ICP) plays an important role in long-term monitoring and neuro-intensive treatment of patients with a cerebral shunt. Currently, only two complete telemetric implants with different technical features are available worldwide. This prospective pilot study aims to examine patients who had both probes implanted at overlapping times for clinical reasons and represents the first in vivo comparison of both measurement methods.

Materials and methods

Patients with a primary subarachnoid hemorrhage or a spontaneous intracerebral hemorrhage with ventricular hemorrhage who had received a telemetric ICP probe (Raumedic ^® NEUROVENT ^®-P-tel) were included in the study. Conventional external ventricular drainages (EVD) and ventriculoperitoneal shunts with a telemetric ICP probe (Miethke Sensor Reservoir) were implanted in patients with hydrocephalus who required CSF (cerebrospinal fluid) drainage. Absolute ICP values from all systems were obtained. Due to the overlapping implantation time, parallel ICP measurements were performed via two devices simultaneously. ICP measurements via the sensor reservoir were repeated after 3 and 9 months. Differences between the absolute ICP values measured via the NEUROVENT ^®-P-tel probe, the Miethke sensor reservoir ^®, and the EVD were analyzed.

Results

Seventeen patients were included in the present study between 2016 and 2018. 63% of all patients were male. In 11 patients the ICP measurements were followed up with both devices for 3 months. ICP measurements of the sensor reservoir showed corresponding trends in 9 cases compared to ICP measurement via the telemetry probe or EVD. Difference in absolute ICP values ranged between 14.5 mmHg and 0.0 mmHg. The average difference of the absolute ICP values in 8 cases was ≤ 3.5 mmHg.

Conclusion

ICP measurements with both systems continuously showed synchronous absolute ICP values, however absolute values of ICP measurement with the different systems did not match.

Related collections

Most cited references 21

Record: found
Abstract: found
Article: not found

Significance of intracranial hypertension in severe head injury.

Richard Miller, P. Becker, Timothy E. Adams … (1977)

Measurements of intracranial pressure (ICP) were begun within hours of injury in 160 patients with severe brain trauma, and continued in the intensive care unit. Some degree of increased ICP (greater than 10 mm Hg) was present on admission in most cases (82%), and in all but two of the 62 patients with intracranial mass lesions requiring surgical decompression; ICP was over 20 mm Hg on admission in 44% of cases, and over 40 mm Hg in 10%. In patients with mass lesions only very high ICP (greater than 40 mm Hg) on admission was significantly associated with a poor neurological picture and outcome from injury, while in patients with diffuse brain injury any increase in ICP above 10 mm Hg was associated with a poorer neurological status and a worse outcome. Despite intensive measures aimed at prevention of intracranial hypertension, ICP rose over 20 mm Hg during the monitoring period in 64 of the 160 patients (40%). Postoperative increases in ICP over 20 mm Hg (mean) were seen in 52% of the patients who had had intracranial masses evacuated, and could not be controlled by therapy in half of these cases. Even in patients without mass lesions, ICP rose above 20 mm Hg in a third of the cases, despite artificial ventilation and steroid therapy. Of the 48 patients who died, severe intracranial hypertension was the primary cause of death in nearly half and even moderately increased ICP (greater than 20 mm Hg) was associated with higher morbidity in patients with mass lesions and those with diffuse brain injury. Measurement of ICP should be included in management of patients with severe head injury.

0 comments Cited 71 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: not found
Article: not found

Power Comparisons of Shapiro‐Wilk, Kolmogorov‐Smirnov, Lilliefors and Anderson‐Darling tests

M. Razali N., NM Razali, YB Wah … (2011)

0 comments Cited 29 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: found

Is Open Access

Safety and efficacy of gravitational shunt valves in patients with idiopathic normal pressure hydrocephalus: a pragmatic, randomised, open label, multicentre trial (SVASONA)

Johannes Lemcke, Ullrich Meier, Cornelia Müller … (2013)

Objectives To investigate whether gravitational valves reduce the risk of overdrainage complications compared with programmable valves in ventriculoperitoneal (VP) shunt surgery for idiopathic normal pressure hydrocephalus (iNPH). Background Patients with iNPH may benefit from VP shunting but are prone to overdrainage complications during posture changes. Gravitational valves with tantalum balls are considered to reduce the risk of overdrainage but their clinical effectiveness is unclear. Methods We conducted a pragmatic, randomised, multicentre trial comparing gravitational with non-gravitational programmable valves in patients with iNPH eligible for VP shunting. The primary endpoint was any clinical or radiological sign (headache, nausea, vomiting, subdural effusion or slit ventricle) of overdrainage 6 months after randomisation. We also assessed disease specific instruments (Black and Kiefer Scale) and Physical and Mental Component Scores of the Short Form 12 (SF-12) generic health questionnaire. Results We enrolled 145 patients (mean (SD) age 71.9 (6.9) years), 137 of whom were available for endpoint analysis. After 6 months, 29 patients in the standard and five patients in the gravitational shunt group developed overdrainage (risk difference −36%, 95% CI −49% to −23%; p<0.001). This difference exceeded predetermined stopping rules and resulted in premature discontinuation of patient recruitment. Disease specific outcome scales did not differ between the groups although there was a significant advantage of the gravitational device in the SF-12 Mental Component Scores at the 6 and 12 month visits. Conclusions Implanting a gravitational rather than another type of valve will avoid one additional overdrainage complication in about every third patient undergoing VP shunting for iNPH.

0 comments Cited 28 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

S. Rot:

ORCID: http://orcid.org/0000-0002-0110-5766

sergej.rot@rambler.ru

Journal

Journal ID (nlm-ta): Fluids Barriers CNS

Journal ID (iso-abbrev): Fluids Barriers CNS

Title: Fluids and Barriers of the CNS

Publisher: BioMed Central (London )

ISSN (Electronic): 2045-8118

Publication date (Electronic): 17 October 2020

Publication date PMC-release: 17 October 2020

Publication date Collection: 2020

Volume: 17

Electronic Location Identifier: 63

Affiliations

[1 ]GRID grid.460088.2, ISNI 0000 0001 0547 1053, Department of Neurosurgery, , Unfallkrankenhaus Berlin, ; Warener Straße 7, 12683 Berlin, Germany

[2 ]GRID grid.460088.2, ISNI 0000 0001 0547 1053, Department of Radiology and Neuroradiology, , Unfallkrankenhaus Berlin, ; Warener Straße 7, 12683 Berlin, Germany

Author information

S. Rot http://orcid.org/0000-0002-0110-5766

Article

Publisher ID: 225

DOI: 10.1186/s12987-020-00225-0

PMC ID: 7568395

PubMed ID: 33069242

SO-VID: c08f2f4a-7873-4f68-9d05-db5d7ee6d2b0

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 13 May 2020

Date accepted : 8 October 2020

Custom metadata

ScienceOpen disciplines: Neurology

Keywords: neurovent®-p-tel probe,miethke sensor reservoir®,intracranial pressure,external ventricle drainage

Data availability:

ScienceOpen disciplines: Neurology

Keywords: neurovent®-p-tel probe, miethke sensor reservoir®, intracranial pressure, external ventricle drainage

Comparative investigation of different telemetric methods for measuring intracranial pressure: a prospective pilot study

Read this article at

Abstract

Objectives

Materials and methods

Results

Conclusion

Related collections

Karger: Neurology and Neuroscience

Most cited references 21

Significance of intracranial hypertension in severe head injury.

Power Comparisons of Shapiro‐Wilk, Kolmogorov‐Smirnov, Lilliefors and Anderson‐Darling tests

Safety and efficacy of gravitational shunt valves in patients with idiopathic normal pressure hydrocephalus: a pragmatic, randomised, open label, multicentre trial (SVASONA)

Author and article information

Contributors

Journal

Affiliations

Author information

Article

History

Categories

Custom metadata

Comments

Comment on this article

Similar content 384

Cited by 6

Most referenced authors 235