Skip to main content
SpringerLink
Log in

Telemetry in intracranial pressure monitoring: sensor survival and drift

  • Original Article - Neurosurgical technique evaluation
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Abstract

Background

Telemetric intracranial pressure (ICP) monitoring enable long-term ICP monitoring on patients during normal day activities and may accordingly be of use during evaluation and treatment of complicated ICP disorders. However, the benefits of such equipment depend strongly on the validity of the recordings and how often the telemetric sensor needs to be re-implanted. This study investigates the clinical and technical sensor survival time and drift of the telemetric ICP sensor: Raumedic Neurovent-P-tel.

Methods

Implanted telemetric ICP sensors in the period from January 2011 to December 2017 were identified, and medical records reviewed for complications, explantation reasons, and parameters relevant for determining clinical and technical sensor survival time. Explanted sensors were tested in an experimental setup to study baseline drift.

Results

In total, implantation of 119 sensors were identified. Five sensors (4.2%) were explanted due to skin damage, three (2.5%) due to wound infection, and two (1.7%) due to ethylene oxide allergy. No other complications were observed. The median clinical sensor survival time was 208 days (95% CI 150–382). The median technical sensor survival time was 556 days (95% CI 382–605). Explanted sensors had a median baseline drift of 2.5 mmHg (IQR 2.0–5.5).

Conclusion

In most cases, the ICP sensor provides reliable measurements beyond the approved implantation time of 90 days. Thus, the sensor should not be routinely removed after this period, if ICP monitoring is still indicated. However, some sensors showed technical malfunction prior to the CE-approval, underlining that caution should always be taken when analyzing telemetric ICP curves.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Andresen M, Juhler M (2014) Intracranial pressure following complete removal of a small demarcated brain tumor: a model for normal intracranial pressure in humans. J Neurosurg 121(4):797–801

    Article  Google Scholar 

  2. Antes S, Tschan CA, Kunze G, Ewert L, Zimmer A, Halfmann A, Oertel J (2014) Clinical and radiological findings in long-term intracranial pressure monitoring. Acta Neurochir 156(5):1009–1019

    Article  Google Scholar 

  3. Antes S, Tschan CA, Heckelmann M, Breuskin D, Oertel J (2016) Telemetric intracranial pressure monitoring with the raumedic Neurovent P-tel. World Neurosurg 91:133–148

    Article  Google Scholar 

  4. Barber JM, Pringle CJ, Raffalli-Ebezant H, Pathmanaban O, Ramirez R, Kamaly-Asl ID (2017) Telemetric intra-cranial pressure monitoring: clinical and financial considerations. Br J Neurosurg 31(3):300–306

    Article  Google Scholar 

  5. Bousquet J, Michel FÇB (1991) Allergy to formaldehyde and ethylene-oxide. Clin Rev Allergy 9(3–4):357–370

    CAS  PubMed  Google Scholar 

  6. Czosnyka Z, Czosnyka M (2017) Long-term monitoring of intracranial pressure in normal pressure hydrocephalus and other CSF disorders. Acta Neurochir 159(10):1979–1980

    Article  Google Scholar 

  7. Czosnyka M, Pickard JD, Steiner LA (2017) Principles of intracranial pressure monitoring and treatment, 1st ed. Handb Clin Neurol. https://doi.org/10.1016/B978-0-444-63600-3.00005-2

    Chapter  Google Scholar 

  8. Freimann FB, Sprung C, Chopra SS, Vajkoczy P, Wolf S (2013) Large-scale referencing of the telemetric Neurovent-P-tel intracranial pressure sensor in a porcine model. Pediatr Neurosurg 49(1):29–32

    Article  Google Scholar 

  9. Fried HI, Nathan BR, Rowe AS, Zabramski JM, Andaluz N, Bhimraj A, Guanci MMK, Seder DB, Singh JM (2016) The insertion and management of external ventricular drains: an evidence-based consensus statement: a statement for healthcare professionals from the neurocritical care society. Neurocrit Care 24(1):61–81

    Article  Google Scholar 

  10. Jiang G (2010) Design challenges of implantable pressure monitoring system. Front Neurosci 4(FEB):2–5

    PubMed Central  Google Scholar 

  11. Kiefer M, Antes S, Leonhardt S, Schmitt M, Orakcioglu B, Sakowitz OW, Eymann R (2012) Telemetric ICP measurement with the first CE-approved device: data from animal experiments and initial clinical experiences. Acta Neurochir (Suppl):111–116

  12. Kotzar G, Freas M, Abel P, Fleischman A, Roy S, Zorman C, Moran JM, Melzak J (2002) Evaluation of MEMS materials of construction for implantable medical devices. Biomaterials 23(13):2737–2750

    Article  CAS  Google Scholar 

  13. Lilja A, Andresen M, Hadi A, Christoffersen D, Juhler M (2014) Clinical experience with telemetric intracranial pressure monitoring in a Danish neurosurgical center. Clin Neurol Neurosurg 120:36–40

    Article  Google Scholar 

  14. Lilja-Cyron A, Kelsen J, Andresen M, Fugleholm K, Juhler M (2018) Feasibility of telemetric intracranial pressure monitoring in the neuro intensive care unit. J Neurotrauma 35(14):1578–1586

    Article  Google Scholar 

  15. Lozier AP, Sciacca RR, Romagnoli MF, Connolly ES, McComb JG, Cohen AR, Rock JP (2002) Ventriculostomy-related infections: a critical review of the literature. Neurosurgery 51(1):170–182

    Article  Google Scholar 

  16. Raboel PH, Bartek J, Andresen M, Bellander BM, Romner B (2012) Intracranial pressure monitoring: invasive versus non-invasive methods-a review. Crit Care Res Pract 2012:3–7

    Google Scholar 

  17. Sæhle T, Eide PK (2015) Intracranial pressure monitoring in pediatric and adult patients with hydrocephalus and tentative shunt failure: a single-center experience over 10 years in 146 patients. J Neurosurg 122(5):1076–1086

    Article  Google Scholar 

  18. Schuhmann MU, Sood S, McAllister JP, Jaeger M, Ham SD, Czosnyka Z, Czosnyka M (2008) Value of overnight monitoring of intracranial pressure in hydrocephalic children. Pediatr Neurosurg 44(4):269–279

    Article  Google Scholar 

  19. Welschehold S, Schmalhausen E, Dodier P, Vulcu S, Oertel J, Wagner W, Tschan CA (2012) First clinical results with a new telemetric intracranial pressure-monitoring system. Oper Neurosurg 70(1):44–49

    Article  Google Scholar 

  20. Wiegand C, Richards P (2007) Measurement of intracranial pressure in children: a critical review of current methods. Dev Med Child Neurol 49(12):935–941

    Article  CAS  Google Scholar 

  21. Yu L, Kim BJ, Meng E (2014) Chronically implanted pressure sensors: challenges and state of the field. Sensors (Switzerland) 14(11):20620–20644

    Article  Google Scholar 

  22. Zacchetti L, Magnoni S, Di Corte F, Zanier ER, Stocchetti N (2015) Accuracy of intracranial pressure monitoring: systematic review and meta-analysis. Crit Care 19(1):1–8

    Article  Google Scholar 

  23. Zhang X, Medow JE, Iskandar BJ, Wang F, Shokoueinejad M, Koueik J, Webster JG (2017) Invasive and noninvasive means of measuring intracranial pressure: a review. Physiol Meas 38(8):R143–R182

    Article  Google Scholar 

  24. Zhong J, Dujovny M, Park HK, Perez E, Perlin AR, Diaz FG (2003) Advances in ICP monitoring techniques. Neurol Res 25(4):339–350

    Article  Google Scholar 

Download references

Acknowledgements

The authors are grateful for critical feedback from Torben Skovbo Hansen.

Funding

Financial support was received by the Lundbeck Foundation. The grant was given to Nicolas Hernandez Norager and included salary.

Author information

Authors and Affiliations

  1. Clinic of Neurosurgery, Copenhagen University Hospital, Blegdamsvej 9, 2100, Copenhagen, Denmark

    Nicolas Hernandez Norager, Alexander Lilja-Cyron, Sara Duus & Marianne Juhler

  2. Department of Neurosurgery, Aalborg University Hospital, Aalborg, Denmark

    Carsten Reidies Bjarkam

  3. Clinic of Neurosurgery, Aarhus University Hospital, Aarhus, Denmark

    Marianne Juhler

Authors
  1. Nicolas Hernandez Norager
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alexander Lilja-Cyron
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Carsten Reidies Bjarkam
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sara Duus
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Marianne Juhler
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nicolas Hernandez Norager.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The project was approved by the Data Protection Agency (journal number 2012-58-004). No ethics committee approval was needed, since the study is retrospective without patient identifiable data.

Consent

For this type of study, formal consent was not required.

Additional information

This article is part of the Topical Collection on Neurosurgical technique evaluation

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Norager, N.H., Lilja-Cyron, A., Bjarkam, C.R. et al. Telemetry in intracranial pressure monitoring: sensor survival and drift. Acta Neurochir 160, 2137–2144 (2018). https://doi.org/10.1007/s00701-018-3691-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00701-018-3691-9

Keywords

Search

Navigation