Continuous monitoring of brain tissue pressure can now be achieved with intracerebral placement of fiberoptic microtransducers. This study was undertaken to test the safety, accuracy, and reliability of this relatively new type of intracranial pressure (ICP) monitoring. Initially, the fiberoptic device was compared with a concurrently functioning intraventricular catheter in 18 patients. The results from the two methods corresponded closely over a wide range of pressures, and the correlation coefficient approached 1.0. Subsequently, this monitor was used for routine measurement of ICP in a series of almost 200 neurosurgical patients at risk of intracranial hypertension. The tracings showed good wave forms and consistent absolute values of ICP. No instances of hemorrhage, mechanical failure, or other complications were associated with this monitor, except one case of infection, which was not directly attributable to the device per se. When bilateral intraparenchymal pressures were recorded in patients with unilateral mass lesions, significant transitory pressure differentials between the ipsilateral and contralateral sides were documented. It is concluded that monitoring intraparenchymal pressure with the fiberoptic device offers safe and reliable ICP recordings for routine neurosurgical practice. In patients with unilateral masses, ICP should be measured in close proximity to the lesion.
[1]
A. Mendelow,et al.
A clinical evaluation of the Camino subdural screw and ventricular monitoring kits.
,
1990,
Neurosurgery.
[2]
J. Hoff,et al.
Brain tissue pressure: physiological observations in anesthetized cats.
,
1984,
Journal of neurosurgery.
[3]
R. Narayan,et al.
Evaluation of a fiberoptic intracranial pressure monitor.
,
1990,
Journal of neurosurgery.
[4]
H. Winn,et al.
Differential intracranial pressure in patients with unilateral mass lesions.
,
1982,
Journal of neurosurgery.
[5]
Z L Gokaslan,et al.
Clinical experience with a continuous monitor of intracranial compliance.
,
1989,
Journal of neurosurgery.
[6]
M. Zornow,et al.
Continuous monitoring of intracranial pressure with a miniaturized fiberoptic device.
,
1987,
Journal of neurosurgery.
[7]
S. Kobayashi,et al.
Intracranial pressure in head-injured patients with various intracranial lesions is identical throughout the supratentorial intracranial compartment.
,
1987,
Neurosurgery.
[8]
C. Nordström,et al.
A comparison of intraparenchymatous and intraventricular pressure recording in clinical practice.
,
1987,
Journal of neurosurgery.