Pediatric Neurosurgery, Campus Virchow Klinikum, Charité, Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany.
Department of Neurosurgery, Charité Campus Mitte, Universitätsmedizin Berlin, Berlin, Germany.
Acta Neurochir (Wien). 2020 Oct;162(10):2487-2497. doi: 10.1007/s00701-020-04421-7. Epub 2020 Jun 3.
Hydrocephalus may present with heterogeneous signs and symptoms. The indication for its treatment and the optimal drainage in complex cases may be challenging. Telemetric intracranial pressure measurements (TICPM) may open new perspectives for those circumstances. We report our experiences using the Neurovent-P-tel and the Sensor Reservoir in a retrospective study.
A series of 21 patients (age range 10-39.5 years) treated in our Pediatric Neurosurgical Unit receiving a TICPM was analyzed. In 8 patients, a Neurovent-P-Tel was implanted; 13 patients received a Sensor Reservoir, 6 of which as a stand-alone implant, while 7 were already shunted. TICPM were performed on an outpatient basis. Possible complications, follow-up surgeries, and TICPM were analyzed.
Concerning the complications, one infection was seen in each group and one postoperative seizure was observed in the P-tel group. TICPM-assisted shunt adjustments lead to clinical improvements in six patients in the P-tel group and six patients in the Sensor Reservoir group. In four out of six non-shunted patients, TICPM contributed to the indication toward shunt implantation.
TICPM seems to be a promising tool to improve clinical management of shunted patients with complex hydrocephalus. The two available systems will need further technical improvements, concerning implantation time, measurements, and data analysis in order to optimize handling and interpretation of the data.
脑积水可能表现出不同的症状和体征。在复杂病例中,其治疗指征和最佳引流方法可能具有挑战性。遥测颅内压测量(TICPM)可能为这些情况开辟新的视角。我们在回顾性研究中报告了使用 Neurovent-P-tel 和 Sensor Reservoir 的经验。
分析了在我们小儿神经外科病房接受 TICPM 治疗的 21 例患者(年龄 10-39.5 岁)的系列病例。8 例患者植入了 Neurovent-P-tel;13 例患者植入了 Sensor Reservoir,其中 6 例为独立植入,7 例已经分流。TICPM 是在门诊进行的。分析了可能的并发症、后续手术和 TICPM。
关于并发症,每组各有 1 例感染,P-tel 组有 1 例术后癫痫发作。TICPM 辅助分流调整使 P-tel 组的 6 例和 Sensor Reservoir 组的 6 例患者的临床状况得到改善。在 6 例未分流的患者中,有 4 例 TICPM 有助于确定是否需要植入分流管。
TICPM 似乎是一种有前途的工具,可以改善复杂脑积水患者的分流治疗管理。为了优化数据的处理和解释,两种可用的系统需要进一步改进植入时间、测量和数据分析。