The Relationship between Ventricular Fluid Pressure and Body Position in Normal Subjects and Subjects with Shunts: A Telemetric Study

Neurosurgery ◽  
1990 ◽  
Vol 26 (2) ◽  
pp. 181-189 ◽  
Author(s):  
Paul H. Chapman ◽  
Eric R. Cosman ◽  
Michael A. Arnold
Keyword(s):  
Intracranial Pressure ◽  
Body Position ◽  
Fluid Pressure ◽  
Quantitative Relationship ◽  
Normal Subjects ◽  
Pressure Regulation ◽  
Reliable Measurement ◽  
Ventricular Fluid Pressure ◽  
The Relationship ◽  
Antisiphon Device

Abstract Using a chronically implanted telemetric pressure sensor, we have determined the quantitative relationship between changes in body position and ventricular fluid pressure in normal subjects and subjects with shunts. The method allows accurate, reliable measurement of negative as well as positive pressures. We describe the derangement of postural intraventricular pressure regulation caused by placement of a shunt, as well as the influence of various shunt systems and the antisiphon device on this problem. Ventriculoatrial, ventriculoperitoneal, and ventriculopleural shunts all caused similar severely abnormal postural intracranial pressure relationships. The antisiphon device was generally effective in restoring normal pressures in patients in the upright position. We discuss the implications of our findings for understanding the mechanisms of postural intracranial pressure regulation in patients without hydrocephalus.

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.

Effects of intravenous nitroglycerin on the intracranial pressure and volume pressure response

1983 ◽  
Vol 58 (4) ◽  
pp. 562-565 ◽  
Author(s):  
Ghaleb A. Ghani ◽  
Yung Fong Sung ◽  
Michael S. Weinstein ◽  
George T. Tindall ◽  
Alan S. Fleischer
Keyword(s):  
Blood Pressure ◽  
Intracranial Pressure ◽  
Fluid Pressure ◽  
Pressure Response ◽  
Mean Blood Pressure ◽  
Intravenous Nitroglycerin ◽  
Content Type ◽  
Ventricular Fluid Pressure ◽  
The Mean ◽  
Fine Print

✓ Ventricular fluid pressure (VFP) and volume-pressure response were measured during nitroglycerin (NTG) infusion in nine patients anesthetized with N2O and fentanyl. The patients' ventilation was controlled, and PaCO2 was kept at 32 ± 4 mm Hg. When an infusion of 0.01% NTG was given intravenously to decrease the mean blood pressure to 95.1%, 84.7%, and 78.2% of control, the VFP increased from control levels of 9.94 ± 2.14 mm Hg to 12.89 ± 2.25, 15.6 ± 2.85, and 14.43 ± 3.45 mm Hg, respectively. The volume-pressure response showed a significant increase when blood pressure decreased to 84.7% and 78.2% of control. These results suggest that intravenous NTG caused an increase in the intracranial pressure and a decrease in the intracranial compliance.

scholarly journals Reference Values For Intracranial Pressure And Lumbar Cerebrospinal Fluid Pressure: A Systematic Review

2021 ◽  
Author(s):  
Nicolas Hernandez Norager ◽  
Markus Harboe Olsen ◽  
Sarah Hornshoej Pedersen ◽  
Casper Schwartz Riedel ◽  
Marek Czosnyka ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cerebrospinal Fluid ◽  
Intracranial Pressure ◽  
Reference Values ◽  
Supine Position ◽  
Body Position ◽  
Fluid Pressure ◽  
Reference Intervals ◽  
Cerebrospinal Fluid Pressure ◽  
Lumbar Cerebrospinal Fluid

Abstract BackgroundAlthough widely used in the evaluation of the diseased, normal intracranial pressure and lumbar cerebrospinal fluid pressure remains sparsely documented. Intracranial pressure is different from lumbar cerebrospinal fluid pressure. In addition, intracranial pressure differs considerably according to body position of the patient. Despite this, the current reference interval are used indistinguishable for intracranial and lumbar cerebrospinal fluid pressure, and body position dependent reference intervals does not exist. In this study, we aim to establish these reference intervals.MethodA systematic search was conducted in MEDLINE, EMBASE, CENTRAL, and Web of Sciences. Methodological quality was assessed using an amended version of the Joanna Briggs Quality Appraisal Checklist. Intracranial pressure and lumbar cerebrospinal fluid pressure were independently evaluated and subdivided into body positions. Quantitative data were presented with mean ± SD, and 90% reference intervals.ResultsThirty-six studies were included. Nine studies reported values for intracranial pressure, while 27 reported values for the lumbar cerebrospinal fluid pressure. Reference values for intracranial pressure were -5.9 to 8.3 mmHg in the upright position and 0.9 to 16.3 mmHg in supine position. Reference values for lumbar cerebrospinal fluid pressure were 7.2 to 16.8 mmHg and 5.7 to 15.5 mmHg in the lateral recumbent position and supine position, respectively. ConclusionsThis systematic review is the first to provide position-dependent reference values for intracranial pressure and lumbar cerebrospinal fluid pressure. Clinically applicable reference values for normal lumbar cerebrospinal fluid pressure was established, and were in accordance with previously used reference values. For intracranial pressure, this study strongly emphasizes the scarse normal material, and highlights the need for further research on the matter.

Intracranial volume-pressure relationship in man

1983 ◽  
Vol 59 (5) ◽  
pp. 810-816 ◽  
Author(s):  
Joseph Th. J. Tans ◽  
Dick C. J. Poortvliet
Keyword(s):  
Continuous Monitoring ◽  
Fluid Pressure ◽  
Pressure Rise ◽  
Intracranial Volume ◽  
Content Type ◽  
Intensive Monitoring ◽  
Therapeutic Consequences ◽  
Ventricular Fluid Pressure ◽  
The Relationship ◽  
Fine Print

✓ Pressure-volume indices (PVI's) were determined for a heterogeneous group of 40 patients who underwent continuous monitoring of ventricular fluid pressure (VFP). The main purpose was to investigate the relationship between VFP and PVI and to establish the significance of the measured PVI values. Determinations of PVI appear to be useful only when baseline VFP is under 20 mm Hg, maximum VFP is under 30 mm Hg, A-waves are absent, and B-waves do not occur numerously. The authors advocate starting with 1-ml bolus infusions, and then, when the resulting pressure rise exceeds 4 mm Hg, additional bolus infusions can be omitted. Results indicate that 13 ml and 10 ml are the key values for the PVI. A PVI of less than 13 ml indicates the need for either reduction of VFP and improvement of compliance or intensive monitoring of both the VFP and the volume-pressure relationship; if the PVI is below 10 ml, anti-hypertensive treatment is almost always necessary. Values of PVI's between 13 and 18 ml, although pathological, usually have no therapeutic consequences.

A MEMS-based passive hydrocephalus shunt for body position controlled intracranial pressure regulation

2014 ◽  
Vol 16 (4) ◽  
pp. 529-536 ◽  
Author(s):  
Staffan B. Johansson ◽  
Anders Eklund ◽  
Jan Malm ◽  
Göran Stemme ◽  
Niclas Roxhed
Keyword(s):  
Intracranial Pressure ◽  
Body Position ◽  
Pressure Regulation

scholarly journals Reference values for intracranial pressure and lumbar cerebrospinal fluid pressure: a systematic review

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Nicolas Hernandez Norager ◽  
Markus Harboe Olsen ◽  
Sarah Hornshoej Pedersen ◽  
Casper Schwartz Riedel ◽  
Marek Czosnyka ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cerebrospinal Fluid ◽  
Intracranial Pressure ◽  
Reference Values ◽  
Supine Position ◽  
Body Position ◽  
Fluid Pressure ◽  
The Body ◽  
Cerebrospinal Fluid Pressure ◽  
Lumbar Cerebrospinal Fluid

Abstract Background Although widely used in the evaluation of the diseased, normal intracranial pressure and lumbar cerebrospinal fluid pressure remain sparsely documented. Intracranial pressure is different from lumbar cerebrospinal fluid pressure. In addition, intracranial pressure differs considerably according to the body position of the patient. Despite this, the current reference values do not distinguish between intracranial and lumbar cerebrospinal fluid pressures, and body position-dependent reference values do not exist. In this study, we aim to establish these reference values. Method A systematic search was conducted in MEDLINE, EMBASE, CENTRAL, and Web of Sciences. Methodological quality was assessed using an amended version of the Joanna Briggs Quality Appraisal Checklist. Intracranial pressure and lumbar cerebrospinal fluid pressure were independently evaluated and subdivided into body positions. Quantitative data were presented with mean ± SD, and 90% reference intervals. Results Thirty-six studies were included. Nine studies reported values for intracranial pressure, while 27 reported values for the lumbar cerebrospinal fluid pressure. Reference values for intracranial pressure were −  5.9 to 8.3 mmHg in the upright position and 0.9 to 16.3 mmHg in the supine position. Reference values for lumbar cerebrospinal fluid pressure were 7.2 to 16.8 mmHg and 5.7 to 15.5 mmHg in the lateral recumbent position and supine position, respectively. Conclusions This systematic review is the first to provide position-dependent reference values for intracranial pressure and lumbar cerebrospinal fluid pressure. Clinically applicable reference values for normal lumbar cerebrospinal fluid pressure were established, and are in accordance with previously used reference values. For intracranial pressure, this study strongly emphasizes the scarcity of normal pressure measures, and highlights the need for further research on the matter.

A Clinical Evaluation of the Camino Subdural Screw and Ventricular Monitoring Kits

Neurosurgery ◽  
1990 ◽  
Vol 26 (3) ◽  
pp. 421-423 ◽  
Author(s):  
I. R. Chambers ◽  
A. D. Mendelow ◽  
E. J. Sinar ◽  
P. Modha
Keyword(s):  
Regression Analysis ◽  
Intracranial Pressure ◽  
Correlation Coefficient ◽  
Clinical Evaluation ◽  
Fluid Pressure ◽  
Ventricular Catheter ◽  
Clinical Use ◽  
Average Pressure ◽  
Ventricular Fluid Pressure ◽  
Half Minute

Abstract The aim of this study was to compare readings of intracranial pressure from a ventricular catheter with those obtained from a Camino catheter-tipped transducer. The Camino transducer was evaluated in two ways: firstly, when it was inserted by a subdural screw, and secondly, when it was inserted into a ventricular catheter using a ventricular monitoring kit. Data were recorded for 376 hours for the subdural screw method and for 486 hours for the ventricular monitoring kit. Average pressure readings were calculated every 5 minutes (10 half-minute values), and regression analysis was performed. For the subdural screw method, the correlation coefficient was 0.945 (gradient, 1.04; intercept, − 5.51. The results from the ventricular monitoring kit showed that the correlation coefficient was 0.901 (gradient, 0.93; intercept, −0.92. The correlation between recordings of ventricular fluid pressure and the Camino recordings obtained from both subdural screw insertions and ventricular monitoring kits was good, with the subdural screw method proving more accurate and reliable in clinical use.

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