Continuous intracranial pressure monitoring in pseudotumour cerebri: Single centre experience

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.

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.

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.