Intracranial pressure monitoring with the Neurodur-P epidural sensor: a prospective study in patients with adult hydrocephalus or idiopathic intracranial hypertension

2008 ◽  
Vol 108 (5) ◽  
pp. 934-942 ◽  
Author(s):  
Maria A. Poca ◽  
Francisco Martínez-Ricarte ◽  
Juan Sahuquillo ◽  
Roberto Lastra ◽  
Ramón Torné ◽  
...  
Keyword(s):  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Zero Drift ◽  
Icp Monitoring ◽  
Neurosurgical Patients ◽  
Catheter Tip ◽  
Common Technique ◽  
A Prospective Study

Object Continuous intracranial pressure (ICP) monitoring using an epidural sensor is a common technique used in selected neurosurgical patients. The aim of this study was to assess the safety and accuracy of the Neurodur-P epidural sensor in the clinical setting. Methods The zero drift, as well as the medical and technical complications, of using the Neurodur-P sensor placed in the epidural space was evaluated in 106 patients with hydrocephalus of varying causes or with suspected intracranial hypertension. Results The median duration of ICP monitoring was 8 days (interquartile range [IQR] 6–12 days). In 78 (73.6%) of the 106 patients the pressure reading was recorded at sensor removal. No zero drift was observed in 28 sensors. The median drift was 0 mm Hg with an IQR of −1 to 1 mm Hg. No significant differences were found between patients monitored for ≤ 5 days and those monitored for > 5 days (t = 535, p = 0.100). No correlation was found between zero drift and monitoring time (r = 0.153, p = 0.181). Of the 83 patients with a follow-up computed tomography scan, 3 showed a < 1 ml collection of blood at the catheter tip. No clinical infections could be attributed to the devices. Only 1 sensor malfunctioned. Conclusions Continuous ICP monitoring using the Neurodur-P sensor is safe, reliable, and easy to perform. At present, using this device is the authors' standard method for the long-term monitoring of patients with alterations in complex cerebrospinal fluid dynamics or with implanted shunts.

scholarly journals Long-term telemetric intracranial pressure monitoring for diagnosis and therapy optimisation of idiopathic intracranial hypertension

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Victor F. Velazquez Sanchez ◽  
Giath Al Dayri ◽  
Christoph A. Tschan
Keyword(s):  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Complex Disease ◽  
Home Monitoring ◽  
Third Ventriculostomy ◽  
Icp Monitoring ◽  
Home Telemonitoring ◽  
Valve Opening

Abstract Background Idiopathic intracranial hypertension (IIH) is a disease which is difficult to diagnose and moreover difficult to treat. We developed a strategy for long-term telemonitoring of intracranial pressure (ICP), by incorporation of the NEUROVENT®-P-tel System, with the goal of improved diagnosis and consequent therapy of this disease. We highlight the results obtained through this approach. Methods Twenty patients with suspected IIH who were treated in our hospital from August 2014 to October 2020 (16 females, 4 males, median age 36,6 years), were assigned to one of two ICP monitoring settings, “Home-Telemonitoring” (n = 12) and “Home-Monitoring” (n = 8). The ICP data were analysed and used conjointly with the accompanying clinical picture for establishment of IIH diagnosis, and telemonitoring was resumed for therapy optimisation of confirmed cases. Results The diagnosis of IIH was confirmed in 18 of the 20 patients. Various surgical/interventional treatments were applied to the confirmed cases, including ventriculoperitoneal (VP) shunting (n = 15), stenting of the transvers venous sinus (n = 1), endoscopic third ventriculostomy (ETV) (n = 1), and ETV in combination with endoscopic laser-based coagulation of the choroid Plexus (n = 1). Optimal adjustment of the implanted shunt valves was achieved with an average valve opening pressure of 6,3 ± 2,17 cm H2O for differential valves, and of 29,8 ± 3,94 cm H2O for gravitational valves. The Home-Telemonitoring setting reduced consequent outpatient visits, compared to the Home-Monitoring setting, with an average of 3,1 visits and 4,3 visits, respectively. No complications were associated with the surgical implantation of the P-tel catheter. Conclusion This study offers insight into the use of long-term ICP monitoring for management of IIH patients in combination with dual-valve VP shunts. The use of NEUROVENT® P-tel system and potentially other similar fully implantable ICP-monitoring devices, albeit invasive, may be justified in this complex disease. The data suggest recommending an initial adjustment of dual-valve VP-shunts of 30 and 6 cm H2O, for gravitational and differential valves, respectively. Further research is warranted to explore potential integration of this concept in IIH management guidelines.

ASSESSMENT OF ZERO DRIFT IN THE CODMAN INTRACRANIAL PRESSURE MONITOR

Neurosurgery ◽  
2009 ◽  
Vol 64 (1) ◽  
pp. 94-99 ◽  
Author(s):  
Yahia Z. Al-Tamimi ◽  
Adel Helmy ◽  
Seb Bavetta ◽  
Stephen J. Price
Keyword(s):  
Intracranial Pressure ◽  
Interquartile Range ◽  
Zero Drift ◽  
Neurointensive Care ◽  
Icp Monitoring ◽  
Pressure Monitor ◽  
Wide Range ◽  
Neurosurgical Patients

Abstract OBJECTIVE Intraparenchymal monitoring devices play an important role in the daily management of head injury and other critically ill neurosurgical patients. Although zero drift data exist for the Camino system (Camino Laboratories, San Diego, CA), only in vitro data exist for the Codman system (Codman and Shurtleff, Inc., Raynham, MA). The aim of this study was to assess the extent of zero drift for the Codman intracranial pressure (ICP) monitor in patients being monitored in 2 neurointensive care units. METHODS This was a prospective study conducted at 2 neurointensive care units. Eighty-eight patients who required ICP monitoring and who presented to the 2 neurosurgical departments, Center 1 (n = 48) and Center 2 (n = 40), were recruited for participation. The duration of ICP monitoring was noted, as was the resultant pressure reading in normal saline on removing the ICP monitor (zero drift). RESULTS The median absolute zero drift for the group was 2.0 mm Hg (interquartile range, 1–3 mm Hg). The median time in situ was 108 hours (interquartile range, 69–201 hours). There was a positive correlation between the drift and time of the probe spent in situ (Spearman's correlation coefficient = 0.342; P = 0.001). Of the readings, 20 and 2% showed a drift greater than 5 and 10 mm Hg in magnitude, respectively. CONCLUSION These data demonstrate that a small amount of zero drift exists in ICP monitors and that this drift increases with time. The wide range in the data demonstrates that some drift readings are quite excessive. This reinforces the school of thought that, although ICP readings contribute significantly to the management of neurosurgical patients, they should be interpreted carefully and in conjunction with clinical and radiological assessment of patients.

scholarly journals Long-Term Follow-up of Patients with Post-Traumatic Refractory High Intracranial Pressure Treated with Lumbar Drainage

2011 ◽  
Vol 39 (1) ◽  
pp. 79-83 ◽  
Author(s):  
J. A. Llompart-Pou ◽  
J. M. Abadal ◽  
J. Pérez-bárcena ◽  
M. Molina ◽  
M. Brell ◽  
...  
Keyword(s):  
Intracranial Pressure ◽  
Lumbar Drainage ◽  
Long Term Follow Up ◽  
Post Traumatic

Long-Term Clinical Results following Correction of Incompetent Superficial and Perforating Veins in Patients with Deep Venous Incompetence and Ulcers

1993 ◽  
Vol 8 (3) ◽  
pp. 128-131 ◽  
Author(s):  
H. Åkesson
Keyword(s):  
Venous Pressure ◽  
Clinical Results ◽  
Venous Ulceration ◽  
Perforating Veins ◽  
Venous Ulcers ◽  
Increased Risk ◽  
A Prospective Study ◽  
Volumetric Measures

Objectives: To assess the presence of venous ulcers following stripping of the saphenous vein and ligation of perforating veins in patients with deep venous incompetence. Design: Retrospective follow-up after a median of 41 months following surgery. Patients: Thirty operated limbs in 25 patients with venous ulcers, originally entering a prospective study of physiological changes following surgery for venous insufficiency. Interventions: An interview regarding absence of ulcers, expressed as a percentage of the follow-up time after surgery – the ‘ulcer-free period’. Correlation with ambulatory venous pressure (AVP) and foot volumetric measures following surgery. Main outcome measures: The presence or absence of venous ulcers. Results: The ulcer-free period for the whole group was 76%. There was a significant (p<0.05) difference in the ulcer-free period in limbs with an AVP below 60 mmHg (89%) compared with limbs with a higher AVP (70%). Conclusion: Failure to normalize AVP with surgery results in persistent high venous pressure and an increased risk of venous ulceration recurrences.

Intracranial Pressure Monitoring

1993 ◽  
Vol 4 (1) ◽  
pp. 148-160
Author(s):  
Therese S. Richmond
Keyword(s):  
Critical Care ◽  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Nursing Care ◽  
Critical Care Nurses ◽  
Intracranial Pressure Monitoring ◽  
Icp Monitoring ◽  
Pressure Monitoring ◽  
Evaluation Of Care ◽  
Planning Intervention

Intracranial pressure monitoring (ICP) is a technology that assists critical care nurses in the assessment, planning, intervention, and evaluation of care. The physiologic basis of intracranial hypertension (ICH) and ICP monitoring are reviewed. Types of monitors arc described. Advantages, disadvantages, and complications of fluid-filled versus fiberoptic systems are explored. Priorities in nursing care of the patient with an ICP monitor are examined

The Different Impacts on the Long-Term Survival of Tunneled Internal Jugular Hemodialysis Catheters Based on Tip Position and Laterality

2017 ◽  
Vol 43 (4) ◽  
pp. 315-320 ◽  
Author(s):  
Vedran Premuzic ◽  
Drazen Perkov ◽  
Ranko Smiljanic ◽  
Bruna Brunetta Gavranic ◽  
Bojan Jelakovic
Keyword(s):  
Superior Vena ◽  
Vena Cava ◽  
The Body ◽  
Term Survival ◽  
Catheter Tip ◽  
Tip Position ◽  
The Impact

Background/Aims: The aim of this study was to examine the impact of different catheter tip positions on the life of the catheter, dysfunction, infection, and quality of hemodialysis and possible differences between the access site laterality in jugular-tunneled hemodialysis catheters. Methods: Catheters were evaluated for the following parameters: place of insertion, time of insertion, duration of use, and reason for removal. In all patients, the catheter tip position was checked using an X-ray. Results: The mean duration of implanted catheters with the tip placed in the cavo-atrial junction and right atrium was significantly longer. There were no differences in catheter functionality at follow-up or complications based on catheter laterality for each catheter tip position. Conclusion: According to our results, the localization of the catheter tip in superior vena cava still remains the least preferable method. Our results showed that the main factor responsible for better catheter functionality was not laterality but the depth to which the catheter tip is inserted into the body.

STEREOTACTIC VENTRICULOPERITONEAL SHUNTING FOR REFRACTORY IDIOPATHIC INTRACRANIAL HYPERTENSION

Neurosurgery ◽  
2007 ◽  
Vol 60 (6) ◽  
pp. 1039-1044 ◽  
Author(s):  
Basel Abu-Serieh ◽  
Keyvan Ghassempour ◽  
Thierry Duprez ◽  
Christian Raftopoulos
Keyword(s):  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Long Term Results ◽  
Ventricular Catheter ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Visual Deficits ◽  
Ventriculoperitoneal Shunting

Abstract OBJECTIVE Recent reports have shown promising short- to medium-term results in patients with refractory idiopathic intracranial hypertension (IIH) treated using the stereotactic ventriculoperitoneal shunting (SVPS) technique. However, the long-term clinical efficacy of this technique remains questionable. This report provides the long-term results of SVPS in treating refractory IIH patients. METHODS We reviewed the medical charts of nine consecutive patients (mean age, 26.4 yr; range, 4–63 yr) treated using either a frame-based or frameless SVPS technique for IIH. RESULTS The mean postoperative follow-up period was 44.3 months (range, 6–110 mo). Before shunting procedures were performed, each patient presented with intractable headache, and five patients (55.6%) had mild to moderate visual deficits. The last follow-up assessment showed that after shunting was performed, eight patients (89%) were headache-free. Only one patient had recurrent headache; however, this patient's pain was much less frequent and severe than before the shunting procedure was completed and was concomitant with recent weight increase. Visual deficits were resolved in three patients and remained stable in two who already had optic nerve atrophy before shunting was completed. Twelve SVPS procedures were performed on our patients. Nine shunt revisions were needed in six patients because of infection (n = 5, including two revisions in one patient), valve dysfunction (n = 2), distal obstruction (n = 1), and ventricular catheter malpositioning (n = 1). No patient had proximal catheter obstruction. CONCLUSION Given the favorable long-term outcome of the SVPS technique for refractory IIH, we are encouraged to apply this procedure on our patients. More invasive approaches should be reserved for patients who have SVPS failure.

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