First clinical results with a new telemetric intracranial pressure-monitoring system.

ABSTRACT

BACKGROUND: The knowledge of intracranial pressure (ICP) is the basis of an appropriate neurosurgical treatment. Because clinical, fundoscopic, or radiological data alone are often elusive, a pre- or postoperative long-term monitoring of the ICP itself is desirable. OBJECTIVE: We describe the first clinical experiences with a new telemetric ICP-monitoring device. METHODS: The transducer of this telemetric intraparenchymal pressure probe is placed under the galea over the calvaria. ICP can be monitored via a special telemetric reader, placed over the intact skin, and the ICP values are stored in a small portable computer. The system does not require an intensive care environment and can be used in any ward or even at home. The system was successfully applied in 10 patients (age, 3-56 years) in whom raised ICP due to hydrocephalus, shunt dysfunction, endoscopic third ventriculostomy failure, craniostenosis, or pseudotumor cerebri was suspected. RESULTS: Continuous telemetric monitoring of ICP was performed for 2 to 24 weeks. In 7 patients, increased ICP values could be excluded, and further surgical maneuvers were avoided. In 3 patients, repeated plateaus or continuously raised ICP indicated surgery resulting in a normalization of ICP. CONCLUSION: This new telemetric system was safe and effective for ICP measurement over a long period, including home monitoring. For the patients, it was easy to handle, and reliable data could be recorded over many weeks. Based on this preliminary experience, the authors consider the new system extremely advantageous in surgical decision making in particularly difficult cases of suspected abnormalities of ICP.