Single center experiences with telemetric intracranial pressure measurements in patients with CSF circulation disturbanc
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ORIGINAL ARTICLE - PEDIATRIC NEUROSURGERY
Single center experiences with telemetric intracranial pressure measurements in patients with CSF circulation disturbances Valentina Pennacchietti 1 & Vincent Prinz 2 & Andreas Schaumann 1 & Tobias Finger 1 & Matthias Schulz 1 & Ulrich W. Thomale 1 Received: 5 November 2019 / Accepted: 19 May 2020 # The Author(s) 2020
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 Ptel 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 . Telemetric . Sensor Reservoir . Neurovent-P-tel
Introduction Hydrocephalus may present with a great variety of signs and symptoms, generally categorized as acute, subacute, and chronic as well as age-dependent symptoms. Its treatment strategies rely on the possibility to solve the underlying cause Valentina Pennacchietti and Vincent Prinz contributed equally to this work. This article is part of the Topical Collection on Pediatric Neurosurgery * Ulrich W. Thomale [email protected] 1
Pediatric Neurosurgery, Campus Virchow Klinikum, Charité, Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany
2
Department of Neurosurgery, Charité Campus Mitte, Universitätsmedizin Berlin, Berlin, Germany
for cerebrospinal fluid (CSF) circulation disturbances. However, the necessity of permanent CSF diverting shunts remains the most often treatment option [7, 8, 16]. Different forces influence shunt drainage such as intraventricular pressure, hydrostatic pressure, acting against intra-abdominal pressure, resistance of the valve, and resistance of tubing [11], combined with factors like type of hydrocephalus, ventricular volume, activ
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