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59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

01. - 04.06.2008, Würzburg

Posterior fossa (intracranial) pressure monitoring experience with 12 patients

Meeting Abstract

  • corresponding author F. Tartara - Neurosurgery, S. Antonio e Biagio Hospital, Alessandria, Italy
  • D. Garbossa - Neurosurgery, S. Antonio e Biagio Hospital, Alessandria, Italy
  • G. Spena - Neurosurgery, S. Antonio e Biagio Hospital, Alessandria, Italy
  • I. Acchiardi - Neurosurgery, S. Antonio e Biagio Hospital, Alessandria, Italy
  • P. Versari - Neurosurgery, S. Antonio e Biagio Hospital, Alessandria, Italy

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocP 110

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2008/08dgnc378.shtml

Veröffentlicht: 30. Mai 2008

© 2008 Tartara et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Objective of the study is the evaluation of feasibility, safety and reliability of posterior fossa intracranial pressure (PFP) monitoring in patients with hemorrhagic-traumatic primary lesions of the posterior fossa. Evaluation of supratentorial-infratentorial pressure gradient and preliminary data analysis in order to suggest clinical usefulness of PFP monitoring.

12 patients were admitted to ICU for posterior fossa SAH (3 cases), cerebellar hemorrhage (6 cases) or cerebellar traumatic contusion (3 cases). Mean GCS at admission was 6. All patients presented triventricular hydrocephalus on admission CT scan. Then a ventricular drain associated with straingauge type microsensor was emergently placed in the operating room to allow deliquoration and ICP monitoring. A perenchimal straingauge type microsensor was placed into posterior fossa (entry point 3 cm behind mastoidal incisura and 2,5 cm below the superior nucal line). Sensor positioning was verified by CT scan. Al the monitoring data were recorded once at hour.

No complications related to sensor positioning into the posterior fossa were detected by CT scan. 5 patients died, 3 presented good recovery and 4 moderate disability. In all patients a statistically significant pressure gradient between posterior fossa (18,3 mmHg ±14,3) and supratentorial compartment (12,2 mmHg ±13,9) was verified (wilcoxon sign rank test).

PFP monitoring is an easy and safe procedure. Correct evaluation of PFP should allow the optimization of perfusion pressure of the posterior fossa (PFPP) in patients with primary lesions of the posterior fossa. Moreover PFP itself and supratentorial-infratentorial pressure gradient should be elements for patients management and for evaluation of therapeutical options (surgical decompression, osmotics agents). Largest number of cases and multicentrical studies will be necessary for a more accurate evaluation of clinical usefulness of monitoring data.