Clinic of Neurosurgery, Copenhagen University Hospital, Inge Lehmanns Vej 6, 2100, Copenhagen East, Denmark.
Clinic of Neurosurgery, Aarhus University Hospital, Aarhus, Denmark.
Fluids Barriers CNS. 2024 May 21;21(1):44. doi: 10.1186/s12987-024-00549-1.
Optimizing the treatment of several neurosurgical and neurological disorders relies on knowledge of the intracranial pressure (ICP). However, exploration of normal ICP and intracranial pressure pulse wave amplitude (PWA) values in healthy individuals poses ethical challenges, and thus the current documentation remains scarce. This study explores ICP and PWA values for healthy adults without intracranial pathology expected to influence ICP.
Adult patients (age > 18 years) undergoing surgery for an unruptured intracranial aneurysm without any other neurological co-morbidities were included. Patients had a telemetric ICP sensor inserted, and ICP was measured in four different positions: supine, lateral recumbent, standing upright, and 45-degree sitting, at day 1, 14, 30, and 90 following the surgery.
ICP in each position did not change with time after surgery. Median ICP was 6.7 mmHg and median PWA 2.1 mmHg in the supine position, while in the upright standing position median ICP was - 3.4 mmHg and median PWA was 1.9 mmHg. After standardization of the measurements from the transducer site to the external acoustic meatus, the median ICP was 8.3 mmHg in the supine position and 1.2 mmHg in the upright standing position.
Our study provides insights into normal ICP dynamics in healthy adults following a uncomplicated surgery for an unruptured aneurysm. These results suggest a slightly wider normal reference range for invasive intracranial pressure than previously suggested, and present the first normal values for PWA in different positions. Further studies are, however, essential to enhance our understanding of normal ICP. Trial registration The study was preregistered at www.
gov (NCT03594136) (11 July 2018).
优化几种神经外科和神经疾病的治疗依赖于对颅内压（ICP）的了解。然而，探索健康个体的正常 ICP 和颅内压脉搏波幅度（PWA）值存在伦理挑战，因此目前的文献仍然很少。本研究探讨了预期不会影响 ICP 的无颅内病变的健康成年人的 ICP 和 PWA 值。
纳入接受未破裂颅内动脉瘤手术且无其他神经合并症的成年患者。患者插入了遥测 ICP 传感器，并在手术后第 1、14、30 和 90 天在四个不同位置（仰卧、侧卧、直立和 45 度坐姿）测量 ICP。
手术后每个位置的 ICP 随时间没有变化。仰卧位时 ICP 的中位数为 6.7mmHg，PWA 的中位数为 2.1mmHg，而直立位时 ICP 的中位数为-3.4mmHg，PWA 的中位数为 1.9mmHg。将测量值从传感器位置标准化到外耳道口后，仰卧位的 ICP 中位数为 8.3mmHg，直立位的 PWA 中位数为 1.2mmHg。
我们的研究提供了健康成年人在未破裂动脉瘤简单手术后正常 ICP 动态的见解。这些结果表明，与之前建议的相比，侵入性颅内压的正常参考范围稍宽，并提出了不同位置的 PWA 的第一个正常值。然而，需要进一步的研究来增强我们对正常 ICP 的理解。
该研究在 www.clinicaltrials.gov 上预先注册（NCT03594136）（2018 年 7 月 11 日）。
