Comparison among Three Methods of Intracranial Pressure Recording

Neurosurgery ◽  
1986 ◽  
Vol 18 (6) ◽  
pp. 730-732 ◽  
Author(s):  
Brian North ◽  
Peter Reilly
Keyword(s):  
Intracranial Pressure ◽  
Intracerebral Hemorrhage ◽  
Ventricular Catheter ◽  
Popular Method ◽  
Pressure Recording ◽  
Ventricular Catheters ◽  
Icp Recording

Abstract Fluid-coupled recording systems are the most popular method of recording intracranial pressure (ICP), but they can be prone to blockage and infection. A series of 378 recordings of ICP was analyzed to identify complications and cases in which recording had to be discontinued prematurely because of catheter blockage. Three different methods of ICP recording were used: a ventricular catheter, a Richmond screw, and a subdural catheter. Richmond screws became blocked more often (16%) than subdural catheters (2.7%) or ventricular catheters (2.5%). Complications of infection and intracerebral hemorrhage were observed mostly in the ventricular catheter patients. Of these three methods, a subdural catheter is the preferred method of recording ICP.

A clinical comparison of subdural screw pressure measurements with ventricular pressure

1983 ◽  
Vol 58 (1) ◽  
pp. 45-50 ◽  
Author(s):  
A. David Mendelow ◽  
John O. Rowan ◽  
Lilian Murray ◽  
Audrey E. Kerr
Keyword(s):  
Head Injury ◽  
Intracranial Pressure ◽  
Severe Head Injury ◽  
Fluid Pressure ◽  
Ventricular Catheter ◽  
Pressure Measurements ◽  
Content Type ◽  
Single Lumen ◽  
Ventricular Fluid Pressure ◽  
Fine Print

✓ Simultaneous recordings of intracranial pressure (ICP) from a single-lumen subdural screw and a ventricular catheter were compared in 10 patients with severe head injury. Forty-one percent of the readings corresponded within the same 10 mm Hg ranges, while 13% of the screw pressure measurements were higher and 46% were lower than the associated ventricular catheter measurements. In 10 other patients, also with severe head injury, pressure measurements obtained with the Leeds-type screw were similarly compared with ventricular fluid pressure. Fifty-eight percent of the dual pressure readings corresponded, while 15% of the screw measurements were higher and 27% were lower than the ventricular fluid pressure, within 10-mm Hg ranges. It is concluded that subdural screws may give unreliable results, particularly by underestimating the occurrence of high ICP.

scholarly journals Intraoperative Fiber-Optic Endoscopy for Ventricular Catheter Insertion

2001 ◽  
Vol 28 (1) ◽  
pp. 56-60 ◽  
Author(s):  
Philip V. Theodosopoulos ◽  
Aviva Abosch ◽  
Michael W. McDermott
Keyword(s):  
Fiber Optic ◽  
Catheter Placement ◽  
Ventricular Catheter ◽  
Neurosurgical Procedure ◽  
Significant Difference ◽  
Catheter Tip ◽  
Endoscopic Guidance ◽  
Ventricular Catheters ◽  
Tip Position ◽  
Optic Endoscopy

ABSTRACT:Objective:Ventricular catheter placement is a common neurosurgical procedure often resulting in inaccurate intraventricular positioning. We conducted a comparison of the accuracy of endoscopic and conventional ventricular catheter placement in adults.Methods:A retrospective analysis of data was performed on 37 consecutive patients undergoing ventriculo-peritoneal shunt (VPS) insertion with endoscopy and 40 randomly selected, unmatched patients undergoing VPS insertion without endoscopy, for the treatment of hydrocephalus of varied etiology. A grading system for catheter tip position was developed consisting of five intraventricular zones, V1-V5, and three intraparenchymal zones, A, B, C. Zones V1 for the frontal approaches and V1 or V2 for the occipital approaches were the optimal catheter tip locations. Postoperative scans of each patient were used to grade the accuracy of ventricular catheter placement.Results:Seventy-six percent of all endoscopic ventricular catheters were in zone V1 and 100% were within zones V1-V3. No endoscopically inserted catheters were observed in zones V4, V5 or intraparenchymally. Thirty-eight percent of the conventionally placed catheters were in zone V1, 53% in zones V1-3 and 15% intraparenchymally. There was a statistically significant difference in the percentage of catheters in optimal location versus in any other location, favoring endoscopic guidance (p<0.001).Conclusion:We conclude that endoscopic ventricular catheter placement provides improved positioning accuracy than conventional techniques.

scholarly journals Translational modeling of non-traumatic raised intracranial pressure in rodents; the impact of diet-induced obesity on cephalic hypersensitivity and retinal degeneration

2021 ◽  
Author(s):  
Connar Stanley James Westgate ◽  
Snorre Malm Hagen ◽  
Ida Marchen Egerod Israelsen ◽  
Steffen Ellitsgaard Hamann ◽  
Rigmor Jensen ◽  
...  
Keyword(s):  
Intracranial Pressure ◽  
Control Diet ◽  
Disease Model ◽  
Fiber Layer ◽  
Diet Induced Obesity ◽  
The Impact ◽  
First Time ◽  
Novel Model ◽  
Icp Recording ◽  
Translational Modeling

Elevated intracranial pressure (ICP) is a feature of critical cerebral disorders. Obesity has been linked to raised ICP, and especially to disorders such as idiopathic intracranial pressure (IIH). We aimed to explore the impact of diet-induced obesity (DIO) on ICP, cephalic sensitivity and structural retinal changes with the dual goal of developing a disease model for non-traumatic raised ICP and IIH. Rats were fed high-fat diet or matched control diet. To assess pain sensitivity, Von Frey and light/dark box testing were performed. Dual energy x-ray absorptiometry scanning was used to measure body composition. Optic nerve head and retinal structures were evaluated using optical coherence tomography. Intraocular pressure was assessed. Rats were then implanted with telemetric device for continuous ICP recording. At the end, eye histology and molecular analysis on choroid plexus (CP) and trigeminal ganglion (TG) were performed. The DIO rats had double the abdominal fat mass. ICP was 55% higher in obese rats (p=0.003). Altered pain thresholds were found in DIO rats as denoted by a lower periorbital threshold (p=0.0002). Expression of Calca and Trpv1 was elevated in TG. Furthermore, a peripapillary retinal nerve fiber layer swelling (p=0.0026) with subsequent neuroretinal degeneration p=0.02) was detected in DIO rats. There was a trend to increased expression of AQP1 and NKCC1 at CP. This study demonstrates for the first time that DIO leads to raised ICP, with clinically relevant sequalae. Our novel model for non-traumatic raised ICP could expand the knowledge regarding disorders with elevated ICP and IIH.

Craniotomy for Fenestration of Multiloculated Hydrocephalus in Pediatric Patients

2005 ◽  
Vol 57 (suppl_1) ◽  
pp. 100-106 ◽  
Author(s):  
David I. Sandberg ◽  
J. Gordon McComb ◽  
Mark D. Krieger
Keyword(s):  
Pediatric Patients ◽  
Neurological Status ◽  
Neurological Deficits ◽  
Ventricular Catheter ◽  
Shunt System ◽  
Neurological Outcomes ◽  
Multiloculated Hydrocephalus ◽  
Before And After ◽  
Posterior Parietal ◽  
Ventricular Catheters

Abstract OBJECTIVE: To assess the treatment of progressive multiloculated hydrocephalus by craniotomy for microsurgical fenestration of cerebrospinal fluid (CSF) compartments to minimize the number of ventricular catheters. METHODS: We studied 33 pediatric patients who underwent craniotomies for fenestration of progressive multiloculated hydrocephalus between 1989 and 2003. In 20 of 33 patients, hydrocephalus was attributed to intraventricular hemorrhage associated with prematurity. Twenty-three of 33 patients had previous central nervous system infections. Craniotomy was typically performed via a posterior parietal approach. Communication between bilateral supratentorial loculated compartments and posterior fossa compartments was achieved. Surgical and neurological outcomes were assessed. RESULTS: Fenestration of loculated CSF spaces was performed successfully in all patients. No new neurological deficits were noted after surgery, and no patients required intraoperative blood transfusions. CSF infections within 3 months after surgery occurred in 4 of 33 patients. Over a median follow-up period of 3.7 years (range, 1.5 mo to 8.7 yr), 19 of 33 patients required additional fenestration procedures. The number of repeat fenestration procedures ranged from one to six, and a total of 47 additional fenestrations were performed in these 19 patients. The majority of patients (n = 25) ultimately required shunt systems with only one ventricular catheter. The neurological status of these patients was extremely poor both before and after surgery. Twenty-nine of 33 patients were severely delayed, and four were mildly delayed. CONCLUSION: Fenestration of multiloculated CSF compartments can enable most patients to function with a single ventricular catheter shunt system. Neurological status remains poor in this patient population.

Erroneous Measurement of Intracranial Pressure Caused by Simultaneous Ventricular Drainage: A Hydrodynamic Model Study

Neurosurgery ◽  
1989 ◽  
Vol 24 (3) ◽  
pp. 348-354 ◽  
Author(s):  
Harold A. Wilkinson ◽  
Jorge Yarzebski ◽  
Edward C. Wilkinson ◽  
Frederick A. Anderson
Keyword(s):  
Intracranial Pressure ◽  
High Pressures ◽  
Ventricular Catheter ◽  
Csf Flow ◽  
Pressure Setting ◽  
Clinical Observations ◽  
Csf Drainage ◽  
Model Study ◽  
Csf Production ◽  
Brain Pressure

Abstract Intracranial pressure (ICP) is often measured from intraventricular catheters, a technique that allows therapeutic drainage of ventricular cerebrospinal fluid (CSF) as an aid in controlling ICP and circumventing obstruction. Drainage of CSF simultaneously with ongoing ICP measurement has been advocated as safe and efficient, and devices are commercially available to permit this practice; however, this concept has been seriously challenged, based on clinical observations. The inaccuracy induced by simultaneous CSF drainage and ICP monitoring is quantitated in this report in a mechanical brain model using a standard ventricular catheter. The following conclusions have been confirmed: 1) rapid CSF drainage induces a severe artifactual reduction in measured ICP, more extreme at higher pressures; 2) calibrated slower rates of CSF drainage produce a severe, although less immediate, reduction in measured ICP; 3) severe artifact appears even in the presence of continuous CSF outflow, so a system that measures ICP only in the presence of CSF flow does not prevent artifact; 4) with simultaneous CSF drainage, measured ICP is determined more by the outflow pressure setting than by actual brain pressure; 5) Since ICP elevation of 25 to 30 mm Hg blocks CSF production, even slow fluid drainage at high pressures should ultimately lead to ventricular collapse and severe artifact.

Slit Ventricle Syndrome Presenting with Paroxysmal Hypersomnia in an Adult: Case Report

Neurosurgery ◽  
1988 ◽  
Vol 22 (3) ◽  
pp. 594-595 ◽  
Author(s):  
Ender Korfali ◽  
Kaya Aksoy ◽  
Imran Safi
Keyword(s):  
Case Report ◽  
Intracranial Pressure ◽  
Shunt Malfunction ◽  
Ventricular Catheter ◽  
Ventricular Enlargement ◽  
Adult Case ◽  
Slit Ventricle Syndrome ◽  
Computed Tomographic ◽  
Lateral Ventricles ◽  
Slit Ventricle

Abstract The slit ventricle syndrome (SVS), defined as intermittent shunt malfunction without substantial ventricular enlargement, is usually observed in shunted children with small, slitlike ventricles. This syndrome has been attributed to recurrent obstruction of the ventricular catheter, which then causes an increase of intracranial pressure. Only rarely has the SVS been reported in adults. We describe a 29-year-old woman whose shunt malfunction presented with longlasting paroxysmal hypersomnia and was diagnosed with computed tomographic evidence of small lateral ventricles. This episodic hypersomnia presented every 2 to 3 weeks and each episode lasted 1 to 2 weeks. After revision of the ventricular catheter, her symptoms stopped and she remained well. (Neurosurgery 22:594-595, 1988)

Computational and experimental study of proximal flow in ventricular catheters

2003 ◽  
Vol 99 (2) ◽  
pp. 426-431 ◽  
Author(s):  
Julian Lin ◽  
Martin Morris ◽  
William Olivero ◽  
Frederick Boop ◽  
Robert A. Sanford
Keyword(s):  
Water Table ◽  
Three Dimensional ◽  
Automated Testing ◽  
Ventricular Catheter ◽  
Shunt Insertion ◽  
Content Type ◽  
Testing Apparatus ◽  
Table Model ◽  
Catheter Tip ◽  
Ventricular Catheters

✓ The treatment of hydrocephalus with shunt insertion is fraught with high failure rates. Evidence indicates that the proximal holes in a catheter are the primary sites of blockage. The authors have studied ventricular catheter designs by using computational fluid dynamics (CFD), two-dimensional water table experiments, and a three-dimensional (3D) automated testing apparatus together with an actual catheter. With the CFD model, the authors calculated that 58% of the total fluid mass flows into the catheter's most proximal holes and that greater than 80% flows into the two most proximal sets of holes within an eight-hole catheter. In fact, most of the holes in the catheters were ineffective. These findings were experimentally verified using two completely different methodologies: a water table model of a shunt catheter and a 3D automated testing apparatus with an actual catheter to visualize flow patterns with the aid of ink. Because the majority of flow enters the catheter's most proximal holes, blockages typically occur at this position, and unlike blockages at distal holes, occlusion of proximal holes results in complete catheter failure. Given this finding, new designs that incorporated varying hole pattern distributions and size dimensions of the ventricular catheter were conceived and tested using two models. These changes in the geometrical features significantly changed the entering mass flow rate distribution. In conclusion, new designs in proximal ventricular catheters with variable hole diameters along the catheter tip allowed fluid to enter the catheter more uniformly along its length, thereby reducing the probability of its becoming occluded.

N-Terminal Pro-Brain Natriuretic Peptide Concentrations After Hypertensive Intracerebral Hemorrhage: Relationship With Hematoma Size, Hyponatremia, and Intracranial Pressure

2017 ◽  
Vol 33 (12) ◽  
pp. 663-670 ◽  
Author(s):  
Fei Li ◽  
Qian-Xue Chen ◽  
Shou-Gui Xiang ◽  
Shi-Zhun Yuan ◽  
Xi-Zhen Xu
Keyword(s):  
Intracranial Pressure ◽  
Intracerebral Hemorrhage ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Linear Regression Analysis ◽  
Peak Level ◽  
Hematoma Volume ◽  
The Mean ◽  
Hypertensive Intracerebral Hemorrhage ◽  
Mean Concentration

Introduction: The role of N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with hypertensive intracerebral hemorrhage (HICH) is poorly understood. This study aimed to investigate the secretion pattern of NT-proBNP in patients with HICH and to assess its relationship with hematoma size, hyponatremia, and intracranial pressure (ICP). Methods: This prospective study enrolled 147 isolated patients with HICH. Blood samples were obtained from each patient, and values of serum NT-proBNP, hematoma size, blood sodium, and ICP were collected for each patient. Results: The peak-to-mean concentration of NT-proBNP was 666.8 ± 355.1 pg/mL observed on day 4. The NT-proBNP levels in patients with hematoma volume >30 mL were significantly higher than those in patients with hematoma volume <30 mL ( P < .05). In patients with severe HICH, the mean concentration of NT-proBNP was statistically higher than that in patients with mild–moderate HICH ( P < .05), and the mean level of NT-proBNP in hyponatremia group was significantly higher than that in normonatremic group ( P < .05). In addition, the linear regression analysis indicated that serum NT-proBNP concentrations were positively correlated with ICP ( r = .703, P < .05) but negatively with blood sodium levels only in patients with severe HICH ( r = −.704, P < .05). The serum NT-proBNP levels on day 4 after admission were positively correlated with hematoma size ( r = .702, P < .05). Conclusion: The NT-proBNP concentrations were elevated progressively and markedly at least in the first 4 days after HICH and reached a peak level on the fourth day. The NT-proBNP levels on day 4 were positively correlated with hematoma size. There was a notable positive correlation between plasma NT-proBNP levels and ICP in patients with severe HICH. Furthermore, only in patients with severe HICH, the plasma NT-proBNP levels presented a significant correlation with hyponatremia, which did not occur in patients with mild–moderate HICH.

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