gms | German Medical Science

Objective: Telemetric pressure monitoring has been established mainly for guiding valve adjustment of VP-Shunts. We report our series of patients in which telemetric pressure monitoring has guided therapy and supported decision making in clinical practice.

Method: Between November 2012 and Oktober 2014 in our department 15 patients (11 male, 4 female) underwent placement of a telemetric pressure sensor either provided by Raumedic or Miethke. Patients' age at surgery ranged from 4 to 35 years of age (mean 14). Indication for surgery in all patients was unclear clinical symptomatology (headaches or neurologic worsening after initial successful neurosurgeical treatment) not clearly explained by imaging studies or the patients history. The follow-up ranges from one month to 23 months (mean 10 months).

Results: In all patients pressure monitoring under daily condition was helpful in guiding therapy decisions. We were suprised about unexpected high pressure in patients with what appeared to be a good clinical condition and unexpected low pressure in patients with a shunt who were obviously overdrained. In one patient we performed a reconstructive cranioplasty, in three patients a VP-shunt was placed and in 6 patients a pre-existing shunt was revised. In five patients no further surgery was performed, since we were assured that no further surgical treatment was indicated at this point.

Conclusions: Telemetric pressure monitoring is a helpful tool to guide clinical decision making in complex or difficult cases. It adds a new component of solid reliable pressure data to clinical judgement and imaging studies and will provide better insight in normal and pathologic ICP in the future.