First Clinical Results With a New Telemetric Intracranial Pressure-Monitoring System

Welschehold, Stefan; Schmalhausen, Eva; Dodier, Philippe; Vulcu, Sonja; Oertel, Joachim; Wagner, W.; Tschan, Christoph A.

doi:10.1227/neu.0b013e31822dda12

Cited by 31 publications

(32 citation statements)

References 17 publications

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“…Published initial clinical experiences with the device, as well as results on zero drift, have been favorable. 13 In that study, 4 probes explanted after 14, 15, 16, and 28 days all showed a zero drift of 0 mm Hg. Measurements were obtained for as long as 180 days after implantation, without incident.…”

Section: Surgery and The Telemetric Devicementioning

confidence: 82%

Intracranial pressure following complete removal of a small demarcated brain tumor: a model for normal intracranial pressure in humans

Andresen¹,

Juhler²

2014

JNS

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Object. Current published normal values for intracranial pressure (ICP) are extrapolated from lumbar CSF pressure measurements and ICP measurements in patients treated for CSF pressure disorders. There is an emerging agreement that true normal ICP values are needed for diagnostic and therapeutic purposes. This study documents normal ICP in humans.Methods. In this study the authors included adult patients scheduled for complete removal of a solitary, clearly demarcated, small brain tumor. The mean age of these patients was 67 years old (range 58-85 years old). Exclusion criteria were intended to create a study population with as normal brains as possible. A new telemetric ICP monitoring device was implanted at the end of surgery and monitoring was conducted 2 and 4 weeks postoperatively.Results. In the supine position, mean ICP was 0.5 ± 4.0 mm Hg at 4 weeks postoperatively. Postural change to the standing position resulted in a decrease in mean ICP to −3.7 ± 3.8 mm Hg. These results show ICP to be considerably lower than previously estimated.Conclusions. This study provides a preliminary reference range for normal ICP in humans. It is the first study to show that ICP in the healthy human brain decreases to negative values when assuming the upright position. If these results are later confirmed in a larger series, they might provide reference values for diagnosis and treatment in patients with CSF-related disorders. New normal values also have implications for future shunt design and the ICP target range in hydrocephalus treatment.

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Section: Surgery and The Telemetric Devicementioning

confidence: 82%

Intracranial pressure following complete removal of a small demarcated brain tumor: a model for normal intracranial pressure in humans

Andresen¹,

Juhler²

2014

JNS

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“…"smart" valves with telemetry and pressure sensors that do not drift, 33,34,88,92,111,131 reinforced kink-resistant catheters, and suture-less connectors.…”

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confidence: 99%

An update on research priorities in hydrocephalus: overview of the third National Institutes of Health-sponsored symposium “Opportunities for Hydrocephalus Research: Pathways to Better Outcomes”

McAllister

Williams

Walker

et al. 2015

JNS

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abbreviatioNs CPC = choroid plexus cauterization; DTI = diffusion tensor imaging; ETV = endoscopic third ventriculostomy; HCRN = Hydrocephalus Clinical Research Network; ICP = intracranial pressure; iNPH = idiopathic NPH; LPA = lysophosphatidic acid; NIH = National Institutes of Health; NPC = neural precursor cell; NPH = normal pressure hydrocephalus; NSC = neural stem cell; PreOL = precursor oligodendroglia; RCT = randomized controlled trial; SVZ = subventricular zone; TNF = tumor necrosis factor; VP = ventriculoperitoneal; VZ = ventricular zone. . International experts gave plenary talks, and extensive group discussions were held for each of the major themes.The conference emphasized patient-centered care and translational research, with the main objective to arrive at a consensus on priorities in hydrocephalus that have the potential to impact patient care in the next 5 years. The current state of hydrocephalus research and treatment was presented, and the following priorities for research were recommended for each theme. 1) Causes of Hydrocephalus-CSF absorption, production, and related drug therapies; pathogenesis of human hydrocephalus; improved animal and in vitro models of hydrocephalus; developmental and macromolecular transport mechanisms; biomechanical changes in hydrocephalus; and age-dependent mechanisms in the development of hydrocephalus. 2) Diagnosis of Hydrocephalus-implementation of a standardized set of protocols and a shared repository of technical information; prospective studies of multimodal techniques including MRI and CSF biomarkers to test potential pharmacological treatments; and quantitative and cost-effective CSF assessment techniques. 3) Treatment of Hydrocephalus-improved bioengineering efforts to reduce proximal catheter and overall shunt failure; external or implantable diagnostics and support for the biological infrastructure research that informs these efforts; and evidencebased surgical standardization with longitudinal metrics to validate or refute implemented practices, procedures, or tests. 4) Outcome in Hydrocephalus-development of specific, reliable batteries with metrics focused on the hydrocephalic 1427

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“…In contrast, several publications reported for the recently introduced Neurovent-P-tel ICP measurement system (Raumedic, Helmbrechts, Germany) more promising results. Welschehold et al [15] presented their first clinical experiences after implanting the Neurovent-P-tel in 10 patients. They described a comfortable handling, no severe complications associated with the implantation and no significant zero-point drift detectable in the atmospheric pressure environment after explantation [15].…”

Section: Discussionmentioning

confidence: 99%

“…Welschehold et al [15] presented their first clinical experiences after implanting the Neurovent-P-tel in 10 patients. They described a comfortable handling, no severe complications associated with the implantation and no significant zero-point drift detectable in the atmospheric pressure environment after explantation [15]. In an experimental study, Orakcioglu et al [10] referenced the telemetric Neurovent-P-tel against the conventional externalized Neurovent-P pressure sensor in a porcine model.…”

Section: Discussionmentioning

confidence: 99%

Large-Scale Referencing of the Telemetric Neurovent-P-tel Intracranial Pressure Sensor in a Porcine Model

Freimann

Sprung²,

Chopra³

et al. 2013

Pediatr Neurosurg

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The Neurovent-P-tel sensor is a promising device for telemetric intracranial pressure (ICP) measurements in cases of complex hydrocephalus. Data on its accuracy within a broad ICP range are missing. We applied a porcine model for large-scale manipulation of the ICP values. The telemetric ICP sensor was referenced against ICP values measured directly from a water column within a riser tube. A total of 34 comparative ICP measurements within an ICP range from 2 cm H₂O to 31 mm Hg were performed. The mean difference between both measurement techniques was 0.4 mm Hg. The limits of agreement, where 95% of differences between both methods are expected, were from -2.4 to 3.1 mm Hg. The telemetric Neurovent-P-tel sensor system provides good accuracy within a broad range exceeding normal ICP values and might be useful in clinical practice.

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First Clinical Results With a New Telemetric Intracranial Pressure-Monitoring System

Cited by 31 publications

References 17 publications

Intracranial pressure following complete removal of a small demarcated brain tumor: a model for normal intracranial pressure in humans

Intracranial pressure following complete removal of a small demarcated brain tumor: a model for normal intracranial pressure in humans

An update on research priorities in hydrocephalus: overview of the third National Institutes of Health-sponsored symposium “Opportunities for Hydrocephalus Research: Pathways to Better Outcomes”

Large-Scale Referencing of the Telemetric Neurovent-P-tel Intracranial Pressure Sensor in a Porcine Model

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