Continuous intracranial pressure monitoring in pseudotumour cerebri: Single centre experience.
OBJECTIVE
Investigating pseudotumour cerebri (PTC) patients who do not fulfil the diagnostic criteria, or those presenting post-shunt insertion with recurrent symptoms and signs, with no clear evidence of shunt malfunction, present a diagnostic challenge. PTC patients who underwent continuous intracranial pressure (ICP) monitoring in our unit were reviewed retrospectively.


RESULTS
Twenty-six ICP monitoring procedures were done on 20 patients. Eleven patients had normal pressure, 2 overdrainage/low pressure, 11 underdrainage/high pressure and 2 variable pressures. On the basis of these results 12 patients were managed conservatively: 11 patients were referred to headache team and 1 patient had readjustment of an adjustable valve shunt setting; of those 3 patients had improved symptoms on their first post-operative clinic review. On the other hand, 14 patients had surgery: 5 had shunt revision and 9 had shunt insertion; of those 5 patients improved.


CONCLUSIONS
ICP monitoring using an intraparenchymal probe is a safe and effective diagnostic technique in investigating PTC when indicated. A multidisciplinary approach achieves best results in terms of successful management and follow-up.
Toma
Ahmed K
AK
Victor Horsley Department of Neurosurgery, The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK. ahmedktoma@yahoo.com
Tarnaris
Andrew
A
Kitchen
Neil D
ND
Watkins
Laurence D
LD
D000328:Adult; D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects*; D004868:Equipment Failure; D005260:Female; D006261:Headache / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D006849:Hydrocephalus / Q000503:physiopathology* / Q000601:surgery; D007427:Intracranial Pressure / Q000502:physiology*; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods*; D011184:Postoperative Period; D011559:Pseudotumor Cerebri / Q000503:physiopathology* / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome