Complications following intracranial pressure monitoring in children: a 6-year single-center experience

Abstract

<jats:sec><jats:title>OBJECTIVE</jats:title><jats:p>Intracranial pressure (ICP) monitoring is an important tool in the neurosurgeon’s armamentarium and is used for a wide range of indications. There are many different ICP monitors available, of which fiber-optic intraparenchymal devices are very popular. Here, the authors document their experience performing ICP monitoring from 2005 to 2015 and specifically complication rates following insertion of the Microsensor ICP monitor.</jats:p></jats:sec><jats:sec><jats:title>METHODS</jats:title><jats:p>A retrospective case series review of all patients who underwent ICP monitoring over a 10-year period from 2005 to 2015 was performed.</jats:p></jats:sec><jats:sec><jats:title>RESULTS</jats:title><jats:p>There were 385 separate operations with an overall complication rate of 8.3% (32 of 385 cases). Hardware failure occurred in 4.2% of cases, the CSF leakage rate was 3.6%, the postoperative hemorrhage rate was 0.5%, and there was 1 case of infection (0.3% of cases). Only patients with hardware problems required further surgery as a result of their complications, and no patient had any permanent morbidity or mortality from the procedure. Younger patients (p = 0.001) and patients with pathologically high ICP (13% of patients with high ICP vs 6.5% of patients with normal ICP; p = 0.04) were significantly more likely to have complications. There was no significant difference in the complication rates between general neurosurgical patients and craniofacial patients (7.6% vs 8.8%, respectively; p = 0.67).</jats:p></jats:sec><jats:sec><jats:title>CONCLUSIONS</jats:title><jats:p>Intraparenchymal ICP monitoring is a safe procedure associated with low complications and morbidity in the pediatric craniofacial and neurosurgical population and should be offered to appropriate patients to assess ICP with the reassurance of the safety record reported in this study.</jats:p></jats:sec>

Lack of association of cranial lacunae with intracranial hypertension in children with Crouzon syndrome and Apert syndrome: a 3D morphometric quantitative analysis

“…The diagnosis of IH in children with syndromic craniosynostosis can be challenging. BTextbook^symptoms such as headache and vomiting are often absent [3], and the gold standard for diagnosis remains invasive monitoring, which, while safe, does carry a small complication rate and need for inpatient admission [4,5]. Therefore, there has been great historical interest in non-invasive modalities for assessing the presence or absence of IH.…”

Nonepileptic Electroencephalographic Correlates of Episodic Increases in Intracranial Pressure

“…Current invasive ICP monitoring methods require expertise and are associated with the risk of infection and hemorrhage. [3][4][5] These limitations render noninvasive ICP monitoring attractive to clinical practice. Continuous electroencephalography (cEEG) has an excellent temporal resolution and reliably detects cerebral ischemia before the clinical deterioration in subarachnoid hemorrhage 6 and during carotid endarterectomy.…”

Severe Pediatric Traumatic Brain Injury Treatment Approaches of Pediatric Intensivists in Turkey PICUs: National Survey Results

“…ICP monitoring with a ventricular catheter is accepted as the most accurate, cheap and reliable method, and meanwhile, the ability to perform cerebrospinal uid drainage is a great advantage, because this is one of the implementations that can be performed in the rst stage in the increased ICP treatment (9). ICP monitoring is recommended in patients with TBI, children with abnormality in the rst brain CT and an initial GCS of 3-8 (3).…”