Antes Sebastian, Tschan Christoph A, Kunze Gerd, Ewert Lara, Zimmer Anna, Halfmann Alexander, Oertel Joachim
Department of Neurosurgery, Saarland University Medical Centre, Homburg/Saar, Germany.
Acta Neurochir (Wien). 2014 May;156(5):1009-19; discussion 1019. doi: 10.1007/s00701-013-1991-7. Epub 2014 Feb 4.
Advantages of telemetric devices for long-term intracranial pressure (ICP) measurement have been mentioned several times in the literature. However, descriptions of associated complications are lacking. Therefore, the presented observational study focused on clinical and radiological findings after insertion of an intraparenchymal telemetric ICP monitor.
Between April 2010 and February 2013, 185 telemetric ICP catheters were implanted for diagnostic purposes. All patients were clinically followed. Radiological, microbiological and clinical data were analysed.
One brain abscess (0.5 %) and two cutaneous infections (1.1 %) occurred in 185 patients. Staphylococcus spp. could be detected in all cases. Six patients (3.2 %) suffered from single new-onset seizures and one patient (0.5 %) from a temporary hemiparesis. Intracerebral haemorrhages occurred in 15.6 %, most of the time as small punctate bleedings. Perifocal oedematous reactions surrounding inserted telemetric catheters could be observed in 46.9 %. Multiple imaging studies revealed a tendency of complete oedema resolution over time.
Infectious as well as haemorrhagic complication rates are well comparable with the common literature. The long-term implantation of an ICP probe does not seem to increase the risk of wound infections or brain abscess formation. Surprisingly, very high numbers of oedematous reactions after insertion of the intraparenchymal ICP monitor were seen. Reasons therefore could only be speculated upon.
文献中多次提及遥测设备用于长期颅内压（ICP）测量的优势。然而，缺乏对相关并发症的描述。因此，本观察性研究聚焦于脑实质内遥测ICP监测器植入后的临床和影像学表现。
2010年4月至2013年2月期间，为诊断目的植入了185根遥测ICP导管。对所有患者进行临床随访。分析了影像学、微生物学和临床数据。
185例患者中发生1例脑脓肿（0.5%）和2例皮肤感染（1.1%）。所有病例均检测到葡萄球菌属。6例患者（3.2%）出现单次新发癫痫，1例患者（0.5%）出现暂时性偏瘫。脑出血发生率为15.6%，大多数情况下为小的点状出血。在46.9%的病例中可观察到插入的遥测导管周围的灶周水肿反应。多次影像学研究显示水肿有随时间完全消退的趋势。
感染性和出血性并发症发生率与常见文献报道相当。ICP探头的长期植入似乎不会增加伤口感染或脑脓肿形成的风险。令人惊讶的是，脑实质内ICP监测器插入后出现了非常高的水肿反应发生率。对此原因只能进行推测。
