gms | German Medical Science

Objective: The dynamics of intracranial pressure (ICP) after shunt surgery in patients with normal pressure hydrocephalus is poorly known. Temporarily implanted intraparenchymal pressure probes have shown to be reliable for precise ICP-monitoring, however, a disadvantage of this method is that the ICP probe has to be explanted after a period of time requiring additional surgery. We present two patients with normal pressure hydrocephalus with an integrated ICP measuring device in the shunt system which allows for long-term postoperative telemetric monitoring of ICP.

Method: Two patients (1 man, 66-year-old, 1 woman, 78-year-old) with normal pressure hydrocephalus underwent shunt surgery using the Aesculap-Miethke SensorReservoir as an ICP measuring device integrated in the shunt system. On the first postoperative day and during the follow-up examination 3 months later, several measurements of ICP were performed using the handheld device to read the SensorReservoirs data. Postural changes such as lying, sitting and standing with different head postures were assessed according to an experimental protocol in a randomized order during which the ICP was measured.

Results: There were clear ICP responses to postural changes, in line with physiologically expected values. Since the highest measurement rate of the Aesculap-Miethke SensorReservoir is 1 Hz, however, the collected data has to be considered as an approximation for actual ICP dynamics.

Conclusions: The Aesculap-Miethke SensorReservoir is an easy-to-use tool to reliably measure intracranial pressure in patients with a shunt system. The sample rate and handling of data acquisition may be further developed. As for the time being, it is difficult to draw therapeutic consequences from interpreting the acquired data.