gms | German Medical Science

Objective: For over 50 years the conventional ICP monitoring has been available for diagnostic and ICP therapy. Since 2009 we have experience with telemetric ICP monitoring with the Neurovent-P-Tel probe. This ICP measuring device enables us for the first time to monitor ICP at home. In a further step we established a new method: Home-Telemonitoring of ICP. We want to present the advantages and disadvantages of telemetric ICP Home-Monitoring versus ICP-Telemonitoring.

Methods: 44 patients with complex Hydrocephalus were treated from 2014 to 2017 (26 male, 18 female, median age 45,5 years). 10 patients underwent conventional ICP monitoring with an intraparechymal externalized Neurovent P probe (Raumedic). In 34 patients the telemetric Neurovent P-tel probe (Raumedic) was implanted. ICP Home-Monitoring was performed in a long-term setting. In addition a new setup for home-monitoring was established. 15 patients underwent the new method: Home-Telemonitoring of ICP via internet and telephone contact.

Results: Home-Monitoring and Home-Telemonitoring of ICP were helpful for better and optimal adjustment of shunt valves or to monitor endoscopic third ventriculostomy in a long term setting. The special setting of Home-Telemonitoring reduced the out-patient visits. Via telephone and internet contact we were able to manage events of clinical symptoms. Immediate decisions after online data analysis were possible. Large data volumes can be managed by this new method over far distancies.

Conclusion: Long term ICP Home-Monitoring and Home-Telemonitoring of ICP enable new treatment strategies in neurosurgical decisions. Complex cases of hydrocephalus can be managed by safe long-term ICP-recording. Home-Telemonitoring of ICP allows online medical decision making. In management of complex hydrocephalus, telemetric ICP long- term monitoring is extremely helpful.