Clinical evaluation of two methods of subdural pressure monitoring

Abstract

Recordings from two different types of subdural pressure monitor with simultaneous intraventricular pressure (IVP) tracings are compared in 20 head-injured patients. In the first 10 patients a fluid-filled catheter was placed subdurally and connected to an external transducer, and in the second 10 the Gaeltec model ICT/b solid state miniature transducer was used. The latter system has the advantage that both zero and calibration checks can be carried out after insertion. Only 44% of the fluid-filled catheter readings corresponded with IVP in series of 10-mm Hg ranges, while 53% of readings were lower; this tendency was more marked at higher pressures. With the Gaeltec transducer, 72% of subdural pressure readings corresponded with IVP, while only 9% were lower and 19% were higher than IVP. The differences may have been due to technical causes or to true pressure differentials. The subdural catheter appears too unreliable for routine clinical use, but the Gaeltec transducer may be a satisfactory alternative to ventricular pressure monitoring.

Intracranial Pressure in Single-Suture Craniosynostosis

“…In such cases it was not felt that the results o f ICP monitoring would alter the timing or nature o f the surgical procedure and monitoring was therefore omitted thus broadening the exclusion crite 237 ria in our series. The measurements in Renier's [2] series were from cranial epidural saline-filled transducers, which have a tendency to under-read [10], also the definition of normal or abnormal ICP in their cases was based only upon the baseline IC P recording. Sustained elevations in ICP (plateau waves) are, however, a frequent feature o f the recording in craniosynostosis, occurring during the active phase o f childhood sleep during which rapid eye move ments are seen and cerebral blood flow is increased [11], These plateaux are more commonly observed in the syn dromic forms o f craniosynostosis and may reflect impaired compliance, they are generally considered to be of patho logical significance [1,3,4) and we have therefore incorpo rated them into our analysis o f ICP .…”

Aspectos técnicos da monitorização da pressão intracraniana pelo método subaracnóideo no traumatismo craniencefálico grave

“…Apesar de algumas restrições sobre a precisão dos dados do parafuso 11 e do cateter 27 , o método subaracnóideo figura como um método de fidedignidade bastante satisfatória, relativa facilidade de implantação e mínimos riscos de lesões adicionais e infecções, além de apresentar custos de aquisição e manutenção bastante reduzidos 9,15,17,24 . A precisão do método subaracnóideo, principalmente com cateteres, foi confirmada por Yano e col. 10 , Mollman e col. A principal desvantagem relacionada ao méto-do, nesta casuística, foi a grande dificuldade para a coleta de LCR, tanto pelo parafuso quanto pelo cateter, o que impossibilitou a análise bioquímica, citológica e microbiológica desse material.…”

Intracranial pressure monitoring in patients with severe traumatic brain injury

“…Çà àмåðèêàíñüêèмè íàö³îíàëüíèмè ñòàíäàðòàмè мîí³òîðèíãó ÂЧТ [14], ïðèñòð³é äëя âèм³ðюâàííя ÂЧТ ïîâèíåí мàòè íàñòóïí³ хàðàêòåðèñòèêè: ä³àïàзîí âèм³ðюâàííя 0-100 мм ðò.ñò., òîчí³ñòü ±2 мм ðò.ñò â ä³àïàзîí³ â³ä 0 äî 20 мм ðò.ñò., мàêñèмàëüíà ïîхèб-êà -10% â ä³àïàзîí³ 20-100 мм ðò.ñò.…”

“…³äïîâ³äíî äî íàâåäåíî¿ êëàñèф³êàö³¿, ñóбäó-ðàëüí³, ñóбàðàхíî¿äàëüí³ òà åï³äóðàëüí³ äàòчèêè (ïíåâмàòèчí³ чè зàïîâíåí³ ð³äèíîю) íàéмåíш òîчí³ щîäî âèм³ðюâàííя ÂЧТ [3]. Óзàãàëüíåíà ïîð³âíяëüíà хàðàêòåðèñòèêà ñóчàñíèх ïðèñòðî¿â äëя âèм³ðю-âàííя ÂЧТ ó ïîòåðï³ëèх зà òяaeêî¿ ЧМТ, îñíîâàíà íà àíàë³з³ äàíèх ë³òåðàòóðè [14,15,21,27,32,35,[40][41][42][43], íàâåäåíà ó òàбë. 1.…”