Skip to main content

Advertisement

SpringerLink
Log in

Some principles of postoperative epidural pressure monitoring

  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Summary

A retrospective analysis is presented of 115 cerebral tumour cases where continuous epidural pressure (EDP) monitoring was carried out postoperatively using an implantable transducer constructed on a coplanar principle. Correct implantation of the transducer is crucial to reliable measurement. The influence of transducer location on EDP is highly significant and can be accounted for at least partly by hydrostatic forces. The effect of postural changes similarly has a hydrostatic component. Clinically complicated cases were usually easily distinguishable from uncomplicated cases with a similar transducer location. EDP is usually low in the absence of complications during the first 6 to 12 hours postoperatively. For postoperative monitoring, an EDP transducer should be placed as near to the site of surgery as possible for maximum sensitivity to local pressure changes and the earliest detection of complications.

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

Similar content being viewed by others

References

  1. Beks, J. W. F., Bosch, D. A., Brock, M. (eds.), Intracranial Pressure III. Berlin-Heidelberg-New York: Springer. 1977.

    Google Scholar 

  2. Beks, J. W. F., Journée, H. L., Albarda, S.,et al., The significance of intracranial pressure monitoring in the postoperative period. In: Intracranial pressure III, pp. 251–254 (Beks, J. W. F., Bosch, D. A., Brock, M., eds.). Berlin-Heidelberg-New York: Springer. 1977.

    Google Scholar 

  3. Brock, M., Beck, J., Markakis, E.,et al., Intracranial pressure gradients associated with experimental cerebral embolism. Stroke3 (1972), 123–130.

    PubMed  Google Scholar 

  4. Brock, M., Dietz, H. (eds.), Intracranial pressure. Berlin-Heidelberg-New York: Springer. 1972.

    Google Scholar 

  5. Browder, J., Meyers, R., Behaviour of the systemic blood pressure, pulse rate and spinal fluid pressure associated with acute changes in intracranial pressure artificially produced. Arch. Surg.36 (1938), 1–19.

    Google Scholar 

  6. Coroneos, N. J., McDowall, D. G., Gibson, R. M.,et al., Measurement of extradural pressure and its relationship to other intracranial pressures. J. Neurol. Neurosurg. Psychiat.36 (1973), 514–522.

    PubMed  Google Scholar 

  7. Coroneos, N. J., Turner, J. M., Gibson, R. M.,et al., Comparison of extradural with intraventricular pressure in patients after head injury. In: Intracranial pressure, pp. 51–58 (Brock, M., Dietz, H., eds.). Berlin-Heidelberg-New York: Springer. 1972.

    Google Scholar 

  8. Dorsch, N. W. C., Stephens, R. J., Symon, L., An intracranial pressure transducer. Biomed. Eng.6 (1971), 452–457.

    PubMed  Google Scholar 

  9. Dorsch, N. W. C., Symon, L., A practical technique for monitoring extradural pressure. J. Neurosurg.42 (1975), 249–257.

    PubMed  Google Scholar 

  10. Dorsch, N. W. C., Symon, L., Intracranial pressure changes in acute ischaemic regions of the primate hemisphere. In: Intracranial pressure (Brock, M., Dietz, H., eds.), pp. 109–114. Berlin-Heidelberg-New York: Springer. 1972.

    Google Scholar 

  11. Gibson, M., McDowall, G., Turner, J.,et al., Clinical experience of a method of continuous intracranial pressure recording in 50 neurosurgical patients. In: Intracranial pressure II (Lundberg, N., Ponten, U., Brock, M., eds.), pp. 496–498. Berlin-Heidelberg-New York: Springer. 1975.

    Google Scholar 

  12. Gieles, A. C. M., Somers, G. H. J., Miniature pressure transducers with a silicon diaphragm. Philips Technical Review33 (1973), 14–20.

    Google Scholar 

  13. Gobiet, W., Ergebnisse intrakranieller Druckmessungen im akuten posttraumatischen Stadium. Anaesthesist26 (1977), 187–195.

    PubMed  Google Scholar 

  14. Gobiet, W., Bock, W. J., Liesgang, J.,et al., Experience with an intracranial pressure transducer readjustable in vivo. J. Neurosurg.39 (1974), 272–276.

    Google Scholar 

  15. Gücer, G., Viernstein, L. J., Chubbusk, J. G.,et al., Clinical evaluation of longterm epidural monitoring of intracranial pressure. Surg. Neurol.12 (1979), 373–377.

    PubMed  Google Scholar 

  16. Guillaume, J., Janny, P., Manometrie intracranielle continue. Rev. Neurol.84 (1951), 131–142.

    PubMed  Google Scholar 

  17. Haas, L. L., Roentgenological skull measurements and their diagnostic applications. Amer. J. Roentgenol.67 (1952), 197–209.

    PubMed  Google Scholar 

  18. Hase, U., Intrakranielle Druckmessung. Neurochirurgia21 (1978), 84–90.

    PubMed  Google Scholar 

  19. Hayakawa, T., Waltz, A., Change of epidural pressures after experimental occlusion of one middle cerebral artery in cats. J. Neurol. Sci.26 (1975), 319–333.

    PubMed  Google Scholar 

  20. Holbourn, A. H. S., The mechanics of trauma with special reference to herniation of cerebral tissue. J. Neurosurg.1 (1944), 190–200.

    Google Scholar 

  21. Hulme, A., Cooper, R., The effects of head position and jugular venous compression on intracranial pressure. A clinical study. In: Intracranial pressure III (Beks, J. W. F., Bosch, D. A., Brock, M., eds.), pp. 259–263. Berlin-Heidelberg-New York: Springer. 1977.

    Google Scholar 

  22. Johnston, I. H., Jennett, B., The place of continuous intracranial pressure monitoring in neurosurgical practice. Acta neurochir. (Wien)29 (1973), 53–63.

    Google Scholar 

  23. Johnston, I. H., Johnston, J. O., Jennett, B., Intracranial pressure changes following head injury. Lancet2 (1970), 433–436.

    PubMed  Google Scholar 

  24. Jorgensen, P. B., Riishede, J., Comparative clinical studies of epidural and ventricular pressure. In: Intracranial pressure (Brock, M., Dietz, H., eds.), pp. 41–45. Berlin-Heidelberg-New York: Springer. 1972.

    Google Scholar 

  25. Langfitt, T. W., Weinstein, J. D., Kassell, N. F.,et al., Transmission of increased intracranial pressure. II. Within the supratentorial space. J. Neurosurg.21 (1964), 998–1005.

    PubMed  Google Scholar 

  26. Lundberg, N., Continuous recording and control of ventricular fluid pressure in neurosurgical practice. Acta Psychiat. Neurol. Scand.36 (1960), Suppl. 149.

    Google Scholar 

  27. Lundberg, N., Ponten, U., Brock, M., eds., Intracranial pressure II. Berlin-Heidelberg-New York: Springer. 1975.

    Google Scholar 

  28. Mackay, R. S., Marg, E., Fast, automatic ocular pressure measurement based on an exact theory. IRE Transactions on Medical Electronics7 (1960), 61–67.

    Google Scholar 

  29. Majors, R., Schettinti, A., Mahig, J.,et al., Intracranial pressures measured with the coplanar pressure transducer. Med. & Biol. Eng.10 (1972), 724–733.

    Google Scholar 

  30. Martin, G., Some physical principles of intracranial pressure measurement. Acta neurochir. (Wien)22 (1979), 129–136.

    Google Scholar 

  31. Matsuda, M., Coneda, S., Hauda, H.,et al., Cerebral haemodynamic changes during plateau waves in brain-tumour patients. J. Neurosurg.50 (1979), 483–488.

    PubMed  Google Scholar 

  32. Miller, J. D., Becker, D. P., Ward, J. D.,et al., Significance of intracranial hypertension in severe head injury. J. Neurosurg.47 (1977), 503–516.

    PubMed  Google Scholar 

  33. Nornes, H., Serck-Hanssen, F., Miniature transducer for intracranial pressure monitoring in man. Acta Neurol. Scand.46 (1970), 203–214.

    Google Scholar 

  34. O'Brien, M. D., Waltz, A. G., Intracranial pressure gradients caused by experimental cerebral ischaemia and oedema. Stroke4 (1973), 694–698.

    PubMed  Google Scholar 

  35. Reulen, H. J., Graham, K., Klatzo, I., Development of pressure gradients within brain tissue during the formation of vasogenic brain oedema. In: Intracranial pressure II (Lundberg, N., Ponten, U., Brock, M., eds.), pp. 233–238. Berlin-Heidelberg-New York: Springer. 1975.

    Google Scholar 

  36. Rosner, M. J., Becker, D. P., ICP monitoring: complications and associated factors. Clin. Neurosurg.23 (1976), 494–519.

    PubMed  Google Scholar 

  37. De Rougement, J., Barge, M., Benabid, A. L., Un nouveau capteur pour la mesure de la pression intracranienne. Valeur de la duremere en tant que membrane de transmettre les pressions. Neurochirurgie17 (1971), 579–590.

    PubMed  Google Scholar 

  38. Schettini, A., McKay, L., Mahig, J.,et al., The response of brain surface pressure to hypercapnic hypoxia and hyperventilation. Anesthesiology36 (1972), 4–12.

    PubMed  Google Scholar 

  39. Schettini, A., McKay, L., Majors, R.,et al., Experimental approach for monitoring brain surface pressure. J. Neurosurg.34 (1971), 38–47.

    PubMed  Google Scholar 

  40. Shulman, K., Marmarou, A., Miller, J. D.,et al., eds., Intracranial Pressure IV. Berlin-Heidelberg-New York: Springer. 1980.

    Google Scholar 

  41. SundbÄrg, G., KjÄllquist, A., Lundberg, N.,et al., Complications due to prolonged ventricular fluid pressure recording in clinical practice. In: Intracranial pressure (Brock, M., Dietz, H., eds.), pp. 348–352. Berlin-Heidelberg-New York: Springer. 1972.

    Google Scholar 

  42. SundbÄrg, G., Nornes, H., Simultaneous recording of the epidural and ventricular fluid pressure. In: Intracranial pressure (Brock, M., Dietz, H., eds.), pp. 46–50. Berlin-Heidelberg-New York: Springer. 1972.

    Google Scholar 

  43. Symon, L., Dorsch, N. W. C., Stephens, R. J., Long term measurement of extradural pressure in “low pressure” hydrocephalus. In: Intracranial pressure (Brock, M., Dietz, H., eds.), pp. 280–285. Berlin-Heidelberg-New York: Springer. 1972.

    Google Scholar 

  44. Turner, J. M., Gibson, R. M., McDowall, D. G.,et al., Further experiences with extradural pressure monitoring. In: Intracranial pressure II (Lundberg, N., Ponten, U., Brock, M., eds.), pp. 397–402. Berlin-Heidelberg-New York: Springer. 1975.

    Google Scholar 

  45. Weinstein, J. D., Langfitt, T. W., Bruno, L.,et al., Experimental study of patterns of brain distortion and ischaemia produced by an intracranial mass. J. Neurosurg.28 (1968), 513–521.

    PubMed  Google Scholar 

  46. Yoneda, S. M., Matsuda, Y., Shimuzu, J.,et al., A new device for continuous measurement of intracranial pressure. Surg. Neurol.1 (1973), 13–15.

    PubMed  Google Scholar 

Download references

Author information

Author notes

  1. M. Belopavlovic, A. Buchthal, J. W. F. Beks & H. L. Journée

    Present address: Department of Neurosurgery and Department of Anaesthesia, University of Groningen, The Netherlands

Authors and Affiliations

    Authors
    1. M. Belopavlovic
      View author publications

      You can also search for this author in PubMed Google Scholar

    2. A. Buchthal
      View author publications

      You can also search for this author in PubMed Google Scholar

    3. J. W. F. Beks
      View author publications

      You can also search for this author in PubMed Google Scholar

    4. H. L. Journée
      View author publications

      You can also search for this author in PubMed Google Scholar

    Rights and permissions

    Reprints and permissions

    About this article

    Cite this article

    Belopavlovic, M., Buchthal, A., Beks, J.W.F. et al. Some principles of postoperative epidural pressure monitoring. Acta neurochir 55, 227–245 (1981). https://doi.org/10.1007/BF01808439

    Download citation

    • Issue Date:

    • DOI: https://doi.org/10.1007/BF01808439

    Keywords

    Search

    Navigation