Single center experiences with telemetric intracranial pressure measurements in patients with CSF circulation disturbances

Acta Neurochir (Wien). 2020 Oct;162(10):2487-2497. doi: 10.1007/s00701-020-04421-7. Epub 2020 Jun 3.

Abstract

Background: Hydrocephalus may present with heterogeneous signs and symptoms. The indication for its treatment and the optimal drainage in complex cases may be challenging. Telemetric intracranial pressure measurements (TICPM) may open new perspectives for those circumstances. We report our experiences using the Neurovent-P-tel and the Sensor Reservoir in a retrospective study.

Methods: A series of 21 patients (age range 10-39.5 years) treated in our Pediatric Neurosurgical Unit receiving a TICPM was analyzed. In 8 patients, a Neurovent-P-Tel was implanted; 13 patients received a Sensor Reservoir, 6 of which as a stand-alone implant, while 7 were already shunted. TICPM were performed on an outpatient basis. Possible complications, follow-up surgeries, and TICPM were analyzed.

Results: Concerning the complications, one infection was seen in each group and one postoperative seizure was observed in the P-tel group. TICPM-assisted shunt adjustments lead to clinical improvements in six patients in the P-tel group and six patients in the Sensor Reservoir group. In four out of six non-shunted patients, TICPM contributed to the indication toward shunt implantation.

Conclusions: TICPM seems to be a promising tool to improve clinical management of shunted patients with complex hydrocephalus. The two available systems will need further technical improvements, concerning implantation time, measurements, and data analysis in order to optimize handling and interpretation of the data.

Keywords: Hydrocephalus; Intracranial pressure; Neurovent-P-tel; Sensor Reservoir; Telemetric.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Cerebrospinal Fluid Shunts / adverse effects
  • Child
  • Female
  • Humans
  • Hydrocephalus / physiopathology*
  • Hydrocephalus / surgery
  • Intracranial Pressure*
  • Male
  • Postoperative Complications / epidemiology
  • Seizures / epidemiology
  • Seizures / etiology
  • Telemetry / methods*