Characterisation of Supra- and Infratentorial ICP Profiles

  • Emmanuel MoyseEmail author
  • Maxime Ros
  • Fouad Marhar
  • Pascal Swider
  • Eric Albert Schmidt
Part of the Acta Neurochirurgica Supplement book series (NEUROCHIRURGICA, volume 122)


In pathophysiology and clinical practice, the intracranial pressure (ICP) profiles in the supratentorial and infratentorial compartments are unclear. We know that the pressure within the skull is unevenly distributed, with demonstrated ICP gradients. We recorded and characterised the supra- and infratentorial ICP patterns to understand what drives the transtentorial ICP gradient.

A 70-year-old man was operated on for acute cerebellar infarction. One supratentorial probe and one cerebellar probe were implanted. Both signals were recorded concurrently and analysed off-line. We calculated mean ICP, ICP pulse amplitude, respiratory waves, slow waves and the RAP index of supra- and infratentorial ICP signals. Then, we measured transtentorial difference and performed correlation analysis for every index.

Supratentorial ICP mean was 8.5 mmHg lower than infratentorial ICP, but the difference lessens for higher values. Both signals across the tentorium showed close correlation. Supra- and infratentorial pulse amplitude, respiratory waves and slow waves also showed a high degree of correlation. The compensatory reserve (RAP) showed good correlation. In this case report, we demonstrate that the mean value of ICP is higher in the posterior fossa, with a strong correlation across the tentorium. All other ICP-derived parameters display a symmetrical profile.


Intracranial pressure Posterior fossa Transtentorial gradient Monitoring Signal processing 


Conflict of Interest Statement

There is no conflict of interest to declare.


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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Emmanuel Moyse
    • 1
    Email author
  • Maxime Ros
    • 1
  • Fouad Marhar
    • 2
  • Pascal Swider
    • 3
  • Eric Albert Schmidt
    • 1
  1. 1.Department of NeurosurgeryHôpital PurpanToulouseFrance
  2. 2.Department of Neuro Anaesthesia – Intensive CareHôpital PurpanToulouseFrance
  3. 3.Institute of Fluid MechanicsPaul Sabatier University IIIToulouseFrance

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