Article
Intracranial pressure in patients with normal pressure hydrocephalus and idiopathic intracranial hypertension after shunt surgery
Intrakranieller Druck in Patienten mit Normaldruckhydrocephalus und idiopathischer intrakranieller Hypertension nach Shuntoperation
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Published: | May 25, 2022 |
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Objective: The characteristics of intracranial pressure (ICP) dynamics in patients after shunt surgery are poorly known. The Aesculap-Miethke SensorReservoir - as an integrated ICP measuring device inline in the shunt system - allows for postoperative telemetric monitoring of ICP. We present a series of seven patients (NPH)(4) who underwent shunt surgery and postoperative assessment of ICP.
Methods: Seven patients (3 men, 4 women) with either normal pressure hydrocephalus or idiopathic intracranial hypertension (IIH)(3) underwent shunt surgery using the Aesculap-Miethke SensorReservoir. For postoperative monitoring of ICP several measurements were performed using the handheld device to read the SensorReservoirs data. ICP was recorded with different shunt valve settings. 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: Both patients with IIH and patients with NPH showed pathological ICP values after shunt surgery. Postural changes induced expected ICP responses. Different shunt valve settings had an impact on variances in ICP.
Conclusion: Although patients benefit clinically from shunt treatment, ICP dynamics stay variable and sometimes within pathological ranges. Further long-term studies are necessary to examine ICP dynamics in shunted patients and to support therapeutic decision making.