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Elective ICP monitoring: how long is long enough?

  • Original Article - Brain Injury
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Abstract

Background

Intracranial pressure monitoring is commonly undertaken to assess and manage acute patients following head injury. However, ICP monitoring can also be a useful diagnostic tool in the management of CSF dynamics in elective patients. To date, there is little published research to suggest how long these elective patients require ICP monitoring in order to gain an accurate picture of a patient’s ICP dynamics. At the author’s institution, a minimum of 48-h data collection is currently undertaken in patients with a suspected ICP abnormality.

Methods

A retrospective audit was undertaken comparing overall median ICP and overall median pulse amplitude data at three time points, 24 h, 48 h and total time analysed (if longer than 48 h). Paired T-test was used to assess if there were statistically significant differences between 24-h versus 48-h monitoring and total duration of monitoring. All patients admitted over a 6-month period for ICPM who met the inclusion/exclusion criteria were included.

Results

Eighteen patients met the criteria. Median age was 45.8 years, range 22–83 years, 12 female and 6 male. No complications were experienced as a result of ICPM. Diagnosis included NPH, IIH, suspected shunt malfunction and Chiari malformation. The results demonstrated that there is no statistical difference between 24 h and 48 h or longer for both overall median ICP and pulse amplitude.

Conclusion

The results of this study demonstrate that ICP monitoring of elective adult patients using a Spiegelberg intraparenchymal bolt for 24 h gives an accurate picture of a patient’s ICP dynamics compared with longer periods of monitoring.

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Abbreviations

CSF:

Cerebrospinal fluid

ICP:

Intracranial pressure

ICPM:

Intracranial pressure monitoring

IIH:

Idiopathic intracranial hypertension

iNPH:

Idiopathic normal pressure hydrocephalus

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Authors and Affiliations

  1. Victor Horsley Department of Neurosurgery, Queen Square, London, UK

    S. D. Thompson, C. L. Craven, A. K. Toma, L. W. Thorne & L. D. Watkins

  2. School of Health and Social Science, City University, London, London, UK

    S. D. Thompson & A. Coutts

Authors
  1. S. D. Thompson
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  2. A. Coutts
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  3. C. L. Craven
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  4. A. K. Toma
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  5. L. W. Thorne
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  6. L. D. Watkins
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Correspondence to S. D. Thompson.

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Thompson, S.D., Coutts, A., Craven, C.L. et al. Elective ICP monitoring: how long is long enough?. Acta Neurochir 159, 485–490 (2017). https://doi.org/10.1007/s00701-016-3074-z

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  • DOI: https://doi.org/10.1007/s00701-016-3074-z

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