Hamada J, Fujioka S, Ushio Y
Department of Neurosurgery, Kumamoto University Medical School, Japan.
Neurosurgery. 1993 May;32(5):780-3; discussion 783-4. doi: 10.1227/00006123-199305000-00010.
To evaluate the usefulness of measuring lumbar intraspinal epidural pressure (ISEDP) measurements for the estimation of intracranial pressure, we studied the relationship between ISEDP and intracranial epidural pressure (ICEDP) in 12 patients with high intracranial pressure after neurosurgical procedures. ISEDP was measured with a Gaeltec catheter-tip pressure transducer placed percutaneously in the lumbar epidural space with a Touhy needle. ICEDP was determined by the conventional method. During the measurement, some manipulations were carried out. ISEDP and ICEDP measurements exhibited a linear correlation. In all but one patient with normal cerebrospinal fluid, ISEDP was 84 to 100% of ICEDP. In patients with mild subarachnoid hemorrhage, ISEDP was 82 to 86% of ICEDP. In patients with severe subarachnoid hemorrhage, ISEDP was 45 to 57% of ICEDP and always fluctuated in parallel with ICEDP. ISEDP accurately reflected ICEDP in response to manipulations such as breath holding, neck compression, compression at the cranial defect, mannitol administration, and coughing. These data suggest that ISEDP measurement is useful in monitoring intracranial pressure in patients with intracranial hypertension. In addition, the measurements can be obtained easily and safely.
为评估测量腰椎椎管内硬膜外压力（ISEDP）对估计颅内压的作用，我们研究了12例神经外科手术后颅内压升高患者的ISEDP与颅内硬膜外压力（ICEDP）之间的关系。ISEDP采用Gaeltec导管尖端压力传感器经皮通过Touhy针置于腰椎硬膜外间隙进行测量。ICEDP通过传统方法测定。测量过程中进行了一些操作。ISEDP和ICEDP测量显示出线性相关性。除1例脑脊液正常的患者外，所有患者的ISEDP为ICEDP的84%至100%。轻度蛛网膜下腔出血患者的ISEDP为ICEDP的82%至86%。重度蛛网膜下腔出血患者的ISEDP为ICEDP的45%至57%，且始终与ICEDP平行波动。ISEDP能准确反映ICEDP对屏气、颈部压迫、颅骨缺损处压迫、甘露醇给药和咳嗽等操作的反应。这些数据表明，ISEDP测量在监测颅内高压患者的颅内压方面是有用的。此外，测量可以轻松、安全地获得。
