MedWire News: A telemetric intracranial pressure (ICP) monitoring system allows continuous measurement over many weeks in hospital wards or even patients' homes, report researchers.
The monitoring system comprises an implantable telemetric ICP probe, a reading device, and a portable recording device. ICP recording occurs when the reading device is placed over the wound dressing or directly on the skin, where it can be fixed by adhesive strips.
Christoph Tschan (Johannes Gutenberg-University, Mainz, Germany) and team used the device successfully in 10 patients, one of whom was just 3 years old. There were five other children, aged from 5 to 14 years, and the other patients were aged between 31 and 56 years. The 3 year old had the device implanted for more than 30 days; the minimum duration of use in the children was 14 days and the maximum was more than 180 days.
The researchers note that ICP measurement using traditional percutaneous devices is cumbersome, restricts the activities of the patient, can only be used for short-term monitoring, and must be done in hospital.
"The authors suggest that this new system will take an especially important role in ICP diagnostics and the monitoring of children," they write in Neurosurgery.
Eight patients were discharged home with the device implanted, and monitoring was undertaken by family members or the patients themselves. Five patients underwent magnetic resonance imaging with the device implanted, without any problems arising.
Most of the patients in the current study needed ICP monitoring because of suspected ICP abnormalities after undergoing neurosurgery for conditions including hydrocephalus, craniosynostosis, and pseudotumor cerebri.
"In several neurosurgical diseases, the course of ICP cannot be reliably assessed on the basis of clinical or radiological data alone," say Tschan et al. "Abnormal ICP may occur as an early or late phenomenon after surgery or otherwise in the course of the disease."
Monitoring confirmed raised ICP in three patients, all of whom underwent additional intervention as a result (ventriculoperitoneal shunt implantation, shunt revision, and redecompression).
"In these three cases, ICP monitoring contributed substantially to surgical decision-making," notes the team.
The other seven patients had normal ICP values. Six avoided repeat interventions and one underwent ventriculoperitoneal shunt explantation.
"The main advantage of this new telemetric ICP-monitoring system is the possibility of long-term measurement under daily life conditions," conclude Tschan et al.
"Especially in patients with intermittent clinical signs of raised ICP, the long-term ICP monitoring at home under daily life conditions offers the possibility to detect raised ICP values, which may be hidden in short-term monitoring."
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