Use of long-term intracranial pressure measurement to assess hydrocephalic patients prior to shunt surgery

1975 ◽  
Vol 42 (3) ◽  
pp. 258-273 ◽  
Author(s):  
Lindsay Symon ◽  
Nicholas W. C. Dorsch
Keyword(s):  
Intracranial Pressure ◽  
Pressure Measurement ◽  
Pressure Profile ◽  
Shunt Surgery ◽  
Raised Intracranial Pressure ◽  
Epidural Pressure ◽  
Content Type ◽  
Pressure Recording ◽  
Fine Print

✓ The authors present their experience with long-term epidural pressure recording in hydrocephalic patients. The technique identifies those with episodically raised intracranial pressure. The effect of shunts on the pressure profile in these patients is described.

Long-term testing of an intracranial pressure monitoring device

2000 ◽  
Vol 93 (5) ◽  
pp. 852-858 ◽  
Author(s):  
Jeffrey S. Kroin ◽  
Robert J. McCarthy ◽  
Lee Stylos ◽  
Keith Miesel ◽  
Anthony D. Ivankovich ◽  
...  
Keyword(s):  
Intracranial Pressure ◽  
Pressure Sensors ◽  
Tissue Reaction ◽  
Capacitive Transducer ◽  
Content Type ◽  
Csf Pressure ◽  
Long Term Monitoring ◽  
Term Monitoring ◽  
Fine Print

Object. Long-term monitoring of intracranial pressure (ICP) is limited by the lack of an implantable sensor with low drift. The goal of this study was to demonstrate that a new capacitive transducer system will produce accurate and stable ICP records over extended periods.Methods. Intracranial pressure sensors were implanted into the frontal white matter of four dogs. In addition, a fluid-filled catheter was placed in the cisterna magna (CM) to measure cerebrospinal fluid (CSF) pressure. The animals were tested using standard physiological maneuvers such as jugular vein compression, head elevation, and CSF withdrawal from and saline injection into the CM to verify that the ICP sensor precisely matched CSF pressure changes. The mean ICP pressure and CM pressure were compared for months to demonstrate that the transducer system produced minimal drift over time.The change in the ICP sensor record closely duplicated that of the CSF waveform in the CM in response to well-known physiological stimuli. More important, mean ICP pressure remained within 3 mm Hg of CM pressure for months, with a mean difference of less than 0.3 mm Hg. Histological examination of the dog brains revealed only minimal tissue reaction to the presence of the sensor.Conclusions. The authors demonstrate a new implantable solid-state sensor that reliably measures ICP for months, with minimal drift. The clinical application of this sensor and its telemetry is for long-term monitoring of patients with head injury, mass lesions, and hydrocephalus.

Oligodendroglioma and cerebral cavernous angioma

1985 ◽  
Vol 62 (1) ◽  
pp. 145-147 ◽  
Author(s):  
Chee Pin Chee ◽  
Robin Johnston ◽  
David Doyle ◽  
Peter Macpherson
Keyword(s):  
Intracranial Pressure ◽  
Contrast Enhancement ◽  
Computerized Tomography ◽  
Vascular Malformation ◽  
Signs And Symptoms ◽  
Cavernous Angioma ◽  
Raised Intracranial Pressure ◽  
Content Type ◽  
Vascular Component ◽  
Fine Print

✓ The authors report a case of frontal lobe oligodendroglioma associated with a cavernous angioma. The patient presented with signs and symptoms of raised intracranial pressure. Computerized tomography with contrast enhancement failed to detect the vascular component. The clinical and pathological significance of the presence of this vascular malformation in an oligodendroglioma is discussed.

Thoracic disc herniation associated with papilledema

1984 ◽  
Vol 61 (6) ◽  
pp. 1132-1134 ◽  
Author(s):  
Shalom D. Michowiz ◽  
Harry Z. Rappaport ◽  
Itzchak Shaked ◽  
Allon Yellin ◽  
Abraham Sahar
Keyword(s):  
Spinal Cord ◽  
Intracranial Pressure ◽  
Intervertebral Disc ◽  
Spastic Paraparesis ◽  
Raised Intracranial Pressure ◽  
Thoracic Disc Herniation ◽  
Spinal Cord Lesions ◽  
Content Type ◽  
Thoracic Disc ◽  
Fine Print

✓ The occurrence of papilledema in a patient with progressive spastic paraparesis due to herniation of the T11–12 intervertebral disc is reported. The papilledema resolved following discectomy. The association and possible pathogenetic mechanisms between spinal cord lesions and signs of raised intracranial pressure are reviewed.

Ventriculoatrial shunt in tuberculous meningitis with hydrocephalus

1971 ◽  
Vol 35 (3) ◽  
pp. 309-313 ◽  
Author(s):  
S. N. Bhagwati
Keyword(s):  
Intracranial Pressure ◽  
Tuberculous Meningitis ◽  
Raised Intracranial Pressure ◽  
Ventriculoatrial Shunt ◽  
Active Stage ◽  
Content Type ◽  
Fine Print

✓ Raised intracranial tension affects the course of tuberculous meningitis adversely. The development of hydrocephalus may account for the raised intracranial pressure. Insertion of a ventriculoatrial shunt significantly alters the course of the disease. The results in seven cases have been detailed and discussed. The levels of consciousness improved, hemiplegia and aphasia practically cleared up, and vision returned even in children who were blind for 4 to 6 weeks. Operation could be performed even in an active stage of the disease without much fear of miliary dissemination.

Considerations in early surgery on good-risk patients with ruptured intracranial aneurysms

1982 ◽  
Vol 56 (2) ◽  
pp. 180-185 ◽  
Author(s):  
Herman Hugenholtz ◽  
Robert G. Elgie
Keyword(s):  
Intracranial Pressure ◽  
Retrospective Analysis ◽  
Intracranial Aneurysms ◽  
Early Operation ◽  
Raised Intracranial Pressure ◽  
Content Type ◽  
Risk Patients ◽  
Ruptured Intracranial Aneurysms ◽  
Good Risk ◽  
Fine Print

✓ A retrospective analysis of 100 consecutive patients with proven ruptured intracranial aneurysms, classified as Botterell Grades I to III on admission, was carried out to evaluate the efficacy of early operation. Surgical and management mortality/morbidity rates were lower for cases in which a single hemorrhage was operated on within 48 hours than when surgery was delayed for 7 days or more. Surgical and management mortality/morbidity rates were worse in good-risk patients treated surgically between the 3rd and 7th days following a hemorrhage, reflecting the increased incidence of postoperative vasospasm and raised intracranial pressure encountered at surgery during this interval.

Experience with an intracranial pressure transducer readjustable in vivo

1974 ◽  
Vol 40 (2) ◽  
pp. 272-276 ◽  
Author(s):  
Wolfgang Gobiet ◽  
Wolfgang Joachim Bock ◽  
Jürgen Liesegang ◽  
Wilhelm Grote
Keyword(s):  
Intracranial Pressure ◽  
Pressure Transducer ◽  
Fluid Pressure ◽  
Zero Point ◽  
Epidural Pressure ◽  
Content Type ◽  
Ventricular Fluid Pressure ◽  
Term Monitoring

✓ A new implantable miniature intracranial pressure transducer is described whose main advantage is the possibility of zero point calibration in vivo. Comparative studies verify that epidural pressure corresponds well with ventricular fluid pressure. During long-term monitoring of 30 patients the transducer proved both safe and reliable.

Enigma of raised intracranial pressure in patients with complex craniosynostosis: the role of abnormal intracranial venous drainage

2001 ◽  
Vol 94 (3) ◽  
pp. 377-385 ◽  
Author(s):  
Wendy J. Taylor ◽  
Richard D. Hayward ◽  
Pierre Lasjaunias ◽  
Jonathan A. Britto ◽  
Dominic N. P. Thompson ◽  
...  
Keyword(s):  
Intracranial Pressure ◽  
Venous Drainage ◽  
Venous Hypertension ◽  
Apert Syndrome ◽  
Raised Intracranial Pressure ◽  
Icp Monitoring ◽  
Venous Anatomy ◽  
Content Type ◽  
Complex Forms ◽  
Fine Print

Object. In this study the authors investigated whether patterns of intracranial venous drainage in children with complex craniosynostosis associated with raised intracranial pressure (ICP) were abnormal and, thus, could support the theory that venous hypertension is a major contributor to raised ICP that can lead to impaired visual function or even blindness in these patients. Methods. The authors analyzed the anatomy of intracranial venous drainage as demonstrated in the results of 24 angiography studies obtained in 23 patients, all of whom had either a craniosynostosis-related syndrome (18 patients) or a nonsyndromic multisutural synostosis (five patients). Twenty-one patients had experienced raised ICP (in 19 patients diagnosis was based on invasive ICP monitoring and in two patients on clinical grounds alone) 1 to 6 weeks before undergoing angiography. Of the two remaining patients (both with Apert syndrome) whose ICP monitoring was normal immediately before angiography, each had undergone two previous cranial vault expansion procedures. On results of 18 angiography studies a 51 to 99% stenosis or no flow at all could be observed in the sigmoid—jugular sinus complex either bilaterally (11 patients) or unilaterally (seven patients). In 11 of these patients a florid collateral circulation through the stylomastoid emissary venous plexus was also seen. Two angiography studies were performed in one patient with Crouzon syndrome. A comparison of the two studies demonstrated a progression of the abnormal venous anatomy in that case. The authors found no obvious correlation between each patient's baseline ICP and the degree of abnormality of their venous anatomy, as judged on the basis of a venous-phase angiography severity score. Conclusions. Based on their findings, the authors assert that in children with complex forms of craniosynostosis in whom other factors, such as hydrocephalus, are absent, abnormalities of venous drainage that particularly affect the sigmoid—jugular sinus complex produce a state of venous hypertension that, in turn, is responsible for the majority of cases of raised ICP. The incidence of these changes is unknown, but an analysis of the ages of the children in this study indicated that the period of particular vulnerability to the effects of venous hypertension lasts until the affected child is approximately 6 years old. After that age the collateral venous drainage through the stylomastoid plexus will likely become sufficient to allow ICP to normalize.

Multiple cerebral gummata

1983 ◽  
Vol 58 (6) ◽  
pp. 959-961 ◽  
Author(s):  
Jonathan Punt
Keyword(s):  
Intracranial Pressure ◽  
Computerized Tomography ◽  
Cerebral Edema ◽  
Ct Scanning ◽  
Raised Intracranial Pressure ◽  
Serological Testing ◽  
Serological Tests ◽  
Content Type ◽  
Fine Print

✓ The case of a patient with multiple small cerebral gummata presenting with severely raised intracranial pressure is reported. The diagnosis, which was quite unexpected, was based on positive serological tests for syphilis. Computerized tomography (CT) showed small enhancing lesions with intense cerebral edema. The patient was treated successfully with penicillin, and resolution of the lesions was observed on CT scanning over a 1-year period. The importance of “routine” serological testing is noted.

Effect of intermittently raised intracranial pressure on breathing pattern, ventilatory response to CO2, and blood gases in anesthetized cats

1976 ◽  
Vol 44 (2) ◽  
pp. 156-167 ◽  
Author(s):  
Sheila Jennett ◽  
J. Brian North
Keyword(s):  
Intracranial Pressure ◽  
Gas Exchange ◽  
Breathing Pattern ◽  
Ventilatory Response ◽  
Blood Gases ◽  
Raised Intracranial Pressure ◽  
Content Type ◽  
Central Depression ◽  
Ventilatory Response To Co2 ◽  
Fine Print

✓ In anesthetised cats, breathing pattern, blood gases, and ventilatory response to CO2 were recorded before and during intermittent 10-minute episodes of hydrostatically raised intracranial pressure. The first effect on breathing was a stimulation which was followed at higher pressures by irregularity, depression, and periods of apnea; hyperventilation at high intracranial pressure (ICP) was rare. Raised ICP did not consistently depress the ventilatory response to CO2 until ventilation during airbreathing was already depressed; therefore, we cannot experimentally justify applying this test clinically to detect incipient ventilatory depression. When hypoxemia developed during raised ICP, it was compatible with the degree of hypoventilation due to central depression of breathing; thus, there was no evidence of a neurally mediated effect on the lungs, causing defective gas exchange.

Subarachnoid hemorrhage and papilledema due to a cervical neurilemmoma

1978 ◽  
Vol 48 (6) ◽  
pp. 1015-1018 ◽  
Author(s):  
Linda M. Luxon ◽  
Michael J. G. Harrison
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Intracranial Pressure ◽  
Unusual Case ◽  
Acute Onset ◽  
Raised Intracranial Pressure ◽  
Content Type ◽  
Clinical Clue ◽  
Symptoms And Signs ◽  
Fine Print

✓ An unusual case of a cervical neurilemmoma is presented. A 67-year-old man developed papilledema on two occasions in association with the symptoms and signs of a subarachnoid hemorrhage (SAH). He proved to have an otherwise asymptomatic cervical neurilemmoma. It is suggested that both acute and subclinical bleeding from such tumors may sometimes underlie the development of raised intracranial pressure occasionally encountered. The clinical clue to the spinal origin of the SAH was an acute onset with root pain. This case is discussed with reference to similar cases in the literature.

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