Prolonged intracranial pressure (ICP) monitoring in non-traumatic pediatric neurosurgical diseases.
BACKGROUND
A limited number of studies have addressed the methods, indications and particular problems that may occur when programming prolonged intracranial pressure (ICP) monitoring in pediatric patients. Parenchymal fiberoptic transducers have been shown to give reliable ICP readings; moreover, they present a relatively low rate of complications, are easily placed and, as they are solid state, they are not subject to obstruction.


METHODS
A recently developed fiberoptic ICP transducer (Codman intraparenchymal sensor) was used to continuously monitor intracranial pressure in seventy children with non-traumatic neurosurgical diseases. The admitting diagnoses were hydrocephalus or shunt-related problems in 33 cases, single-suture (5 cases) or complex (16 cases) craniosynostosis in 21 patients, and sylvian scissure arachnoid cyst (SAC) in 16 cases. A software (ICP monitoring release) designed in our department was used for ICP recording storage and analysis.


RESULTS
Raised ICP values were found in six of the seventeen patients with a suspected active hydyrocephalus, 24% of children with non-syndromic craniosynostosis, 52.8% of syndromic craniosynostosis patients, 50% or the children with a Type 11 SAC and two of the three patients with Type II SAC.


CONCLUSIONS
Overall, prolonged ICP monitoring proved to be extremely useful in guiding surgical indications. The fiberoptic device used in our unit was shown to be reliable and associated with a relatively low rate of complications. Finally, the software allowed easy review and analysis of the obtained data.
Tamburrini
Gianpiero
G
Pediatric Neurosurgical Unit, Catholic University Medical School, Rome, Italy. gtamburrini@hotmail.com
Di Rocco
Concezio
C
Velardi
Francesco
F
Santini
Pietro
P
D016080:Arachnoid Cysts / Q000150:complications / Q000503:physiopathology; D002648:Child; D003398:Craniosynostoses / Q000150:complications / Q000503:physiopathology*; D001330:Electronic Data Processing; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D006849:Hydrocephalus / Q000150:complications / Q000503:physiopathology*; D019586:Intracranial Hypertension / Q000209:etiology* / Q000503:physiopathology; D007427:Intracranial Pressure / Q000502:physiology*; D008297:Male; D008991:Monitoring, Physiologic / Q000295:instrumentation; D014160:Transducers, Pressure