Artikel
Long-term telemetric intracranial pressure monitoring for diagnosis and therapy optimisation of idiopathic intracranial hypertension
Langzeit telemetrische Hirndruckmessung für Diagnose und Therapie der idiopatischen intrakraniellen Hypertension
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Autoren
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Victor F. Velazquez Sanchez
- Krankenhaus Ludmillenstift Meppen, Neurochirurgie, Meppen, Deutschland
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Giath Al Dayri
- Krankenhaus Ludmillenstift Meppen, Neurochirurgie, Meppen, Deutschland
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Christoph A. Tschan
- Krankenhaus Ludmillenstift Meppen, Neurochirurgie, Meppen, Deutschland
| Veröffentlicht: | 4. Juni 2021 |
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Gliederung
Text
Objective: Idiopathic intracranial hypertension (IIH) is a disease which is difficult to diagnose and moreover difficult to treat. We developed a strategy for long-term telemonitoring of intracranial pressure (ICP), by incorporation of the NEUROVENT®-P-tel System, for improved diagnosis and consequent therapy of this disease.
Methods: 20 patients with suspected IIH who were treated in our hospital from August 2014 to October 2020 (16 females, 4 males, median age 36,6 years), were assigned to one of two ICP monitoring settings, “Home-Telemonitoring” (n=12) and “Home-Monitoring” (n=8). The ICP data were analysed and used conjointly with the clinical picture for establishment of IIH diagnosis, and telemonitoring was resumed for therapy optimisation of confirmed cases.
Results: The diagnosis of IIH was confirmed in 18 of the 20 patients. Various surgical/interventional treatments were applied to the confirmed cases, including ventriculoperitoneal (VP) shunting (n=15), stenting of the transvers venous sinus (n=1), endoscopic third ventriculostomy (ETV) (n=1), and ETV in combination with endoscopic laser-based coagulation of the choroid Plexus (n=1). Optimal shunt-valve adjustment was achieved with an average valve opening pressure of 6,3 ± 2,17 cmH2O for differential valves, and of 29,8 ± 3,94 cmH2O for gravitational valves. The Home-Telemonitoring setting reduced consequent outpatient visits, compared to the Home-Monitoring setting, with an average of 3,1 visits and 4,3 visits, respectively. No complications were reported.
Conclusion: This strategy of long-term telemetric ICP monitoring was safe and efficient in the management of IIH, with improved patient outcome, especially in complicated cases. The data suggest an initial adjustment of dual-valve VP-shunts of 30 and 6 cmH2O, for gravitational and differential valves, respectively.
Figure 1 [Fig. 1]
