Clinical experience with telemetric intracranial pressure monitoring in a Danish neurosurgical center

Background

Monitoring of intracranial pressure (ICP) is important in the optimal treatment of various neurological and neurosurgical diseases. Telemetric ICP monitoring allows long-term measurements in the patient’s everyday life and the possibility to perform additional measurements without the procedure related risks of repeated transducer insertions.

Materials and Methods

We identified all patients in our clinic with an implanted Raumedic(®) telemetric ICP probe (NEUROVENT(®)-P-tel). For each patient we identified diagnosis, indication for implantation, surgical complications, duration of ICP reading, number of ICP recording sessions (in relation to symptoms of increased ICP) and their clinical consequence.

Results

We included 21 patients in the evaluation (11 female and 10 male). Median age was 28 (2-83) years and median duration of disease was 11 (0–30) years. Eleven patients had various kinds of hydrocephalus, seven patients had idiopathic intracranial hypertension (IIH) and three patients had normal pressure hydrocephalus (NPH). Fifteen patients had a shunt prior to implantation. Median duration of implantation was 248 (49–666) days and median duration from implantation to last recording session was 154 (8–433) days. In total, 86 recording sessions were performed; 29 resulted in surgical shunt revision, 30 in change of acetazolamide dose or programmable valve setting, 20 required no action and 5 resulted in a new recording session. No surgical complications occurred, except for late wound infection at the surgical site in two patients.

Conclusion

Telemetric ICP monitoring is useful in patients with complicated CSF dynamic disturbances who would otherwise require repeated invasive pressure monitoring. It seems to be a feasible method to guide adjustment of programmable valve settings and to identify patients with chronic or repeated shunt problems.