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Differences in quantitative characteristics of intracranial pressure in hydrocephalic children treated surgically or
Per Kristian Eide1, Bernt Due-Tønnessen, Eirik Helseth
1Department of Neurosurgery, The National Hospital, University of Oslo, Sognvannsveien 20, N-0027 Oslo, Norway. per.kristian.eide@rikshospitalet.no
Insights
Hydrocephalic children treated conservatively showed more intracranial pressure (ICP) elevations than those surgically treated. Quantitative analysis of ICP monitoring offers enhanced insights compared to traditional methods.
Area of Science:
- Pediatric Neurology
- Neurosurgery
- Biomedical Engineering
Background:
- Hydrocephalus is a condition characterized by abnormal accumulation of cerebrospinal fluid in the brain.
- Continuous monitoring of intracranial pressure (ICP) is crucial for managing hydrocephalus in children.
- Traditional ICP analysis methods include mean ICP calculation and visual detection of plateau waves.
Purpose of the Study:
- To quantitatively compare ICP elevations during sleep and wakefulness in pediatric hydrocephalus patients.
- To evaluate differences in ICP patterns between surgically and conservatively treated hydrocephalus groups.
- To assess the utility of a novel quantitative analysis method for ICP monitoring.
Main Methods:
- Quantitative analysis of continuous ICP recordings from 33 hydrocephalic children using Sensometrics Pressure Analyser software.
- ICP curves were analyzed as a matrix of elevations by level (20-40 mm Hg) and duration (0.5-20 min).
- ICP elevation data were standardized to 10-hour recording periods for inter-individual comparison.
Main Results:
- The non-surgery group exhibited a significantly higher number of ICP elevations (e.g., 20 mm Hg for 10 min) compared to the surgery group.
- No significant correlation was found between ICP and patient age or cerebral ventricle size.
- The quantitative matrix method revealed more detailed ICP data than mean ICP or visual plateau wave detection.
Conclusions:
- Quantitative analysis of ICP elevations provides a more informative assessment of ICP dynamics in pediatric hydrocephalus.
- Conservative management in hydrocephalus may be associated with a greater frequency of ICP elevations.
- This matrix-based ICP analysis enhances the diagnostic value of continuous ICP monitoring in pediatric neurosurgery.
Abstract:
This study reports the results of quantitative analysis of continuous intracranial pressure (ICP) recordings in 33 hydrocephalic children. The aim of the study was to compare the exact numbers of increases in ICP during sleep or the awake state in hydrocephalic children who were treated either surgically or conservatively. At the time of ICP monitoring, the ICP curves were assessed by the calculation of mean ICP and visual inspection for the detection of plateau waves. Quantitative analysis was performed with the software Sensometrics Pressure Analyser, which presented the ICP curve as a matrix of numbers of ICP elevations of different levels (20-40 mm Hg) and durations (0.5-20 min). In each case, the numbers of ICP elevations were standardized to 10 h of recording time, providing the opportunity for comparisons of ICP curves between individuals. Compared to the surgery group, there was a rather high number of ICP elevations of 20 mm Hg of various durations in the nonsurgery group, e.g. ICP elevations of 20 mm Hg lasting 10 min occurred in 13 of 19 children (68%) in the nonsurgery group. There was no apparent relationship between ICP and age or between the size of the cerebral ventricles and ICP. In children with hydrocephalus, the presentation of the ICP data as a matrix of ICP elevations of different levels and durations may enhance the informative value of continuous ICP monitoring, as compared to the calculation of mean ICP and visual detection of plateau waves.