Gambardella G, d'Avella D, Tomasello F
Neurosurgical Clinic, University of Messina, Italy.
Neurosurgery. 1992 Nov;31(5):918-21; discussion 921-2. doi: 10.1227/00006123-199211000-00014.
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.
通过将光纤微传感器植入脑组织,现在可以实现对脑组织压力的连续监测。本研究旨在测试这种相对新型的颅内压(ICP)监测方法的安全性、准确性和可靠性。最初,在18名患者中,将光纤装置与同时发挥作用的脑室内导管进行了比较。在很宽的压力范围内,两种方法的结果密切对应,相关系数接近1.0。随后,该监测器被用于对一系列近200名有颅内高压风险的神经外科患者进行ICP的常规测量。记录显示出良好的波形和一致的ICP绝对值。除了1例感染(并非直接归因于该装置本身)外,没有与该监测器相关的出血、机械故障或其他并发症的情况。当对单侧占位性病变患者进行双侧脑实质内压力记录时,记录到同侧和对侧之间存在明显的短暂压力差。得出的结论是,使用光纤装置监测脑实质内压力可为常规神经外科手术提供安全可靠的ICP记录。对于单侧占位性病变患者,应在靠近病变处测量ICP。