University Medicine Mainz, Johannes Gutenberg-University, Department of Neurosurgery, Mainz, Germany.
Neurosurgery. 2012 Mar;70(1 Suppl Operative):44-9; discussion 49. doi: 10.1227/NEU.0b013e31822dda12.
The knowledge of intracranial pressure (ICP) is the basis of an appropriate neurosurgical treatment. Because clinical, fundoscopic, or radiological data alone are often elusive, a pre- or postoperative long-term monitoring of the ICP itself is desirable.
We describe the first clinical experiences with a new telemetric ICP-monitoring device.
The transducer of this telemetric intraparenchymal pressure probe is placed under the galea over the calvaria. ICP can be monitored via a special telemetric reader, placed over the intact skin, and the ICP values are stored in a small portable computer. The system does not require an intensive care environment and can be used in any ward or even at home. The system was successfully applied in 10 patients (age, 3-56 years) in whom raised ICP due to hydrocephalus, shunt dysfunction, endoscopic third ventriculostomy failure, craniostenosis, or pseudotumor cerebri was suspected.
Continuous telemetric monitoring of ICP was performed for 2 to 24 weeks. In 7 patients, increased ICP values could be excluded, and further surgical maneuvers were avoided. In 3 patients, repeated plateaus or continuously raised ICP indicated surgery resulting in a normalization of ICP.
This new telemetric system was safe and effective for ICP measurement over a long period, including home monitoring. For the patients, it was easy to handle, and reliable data could be recorded over many weeks. Based on this preliminary experience, the authors consider the new system extremely advantageous in surgical decision making in particularly difficult cases of suspected abnormalities of ICP.
颅内压（ICP）的知识是进行适当神经外科治疗的基础。由于仅凭临床、眼底或影像学数据往往难以确定，因此希望对 ICP 本身进行术前或术后的长期监测。
我们介绍一种新型遥测 ICP 监测设备的首次临床应用经验。
该遥测脑室内压力探头的换能器置于颅骨上的帽状腱膜下。可以通过特殊的遥测读取器监测 ICP，该读取器置于完整的皮肤上方，ICP 值存储在小型便携式计算机中。该系统不需要重症监护环境，可在任何病房甚至在家中使用。该系统已成功应用于 10 例患者（年龄 3-56 岁），这些患者由于脑积水、分流功能障碍、内镜第三脑室造瘘术失败、颅缝早闭或假性脑瘤而怀疑颅内压升高。
对 7 例患者进行了 2 至 24 周的连续遥测 ICP 监测，排除了升高的 ICP 值，避免了进一步的手术操作。在 3 例患者中，反复出现平台期或持续升高的 ICP 表明需要手术，从而使 ICP 恢复正常。
这种新型遥测系统可安全有效地进行长时间的 ICP 测量，包括家庭监测。对于患者来说，操作简单，可在数周内可靠地记录数据。基于这些初步经验，作者认为该新型系统在疑似 ICP 异常的特别困难病例的手术决策中具有极大优势。
