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A Detailed Protocol for Physiological Parameters Acquisition and Analysis in Neurosurgical Critical Patients
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The initial intracranial pressure spike phenomenon.

Francesco Magni1, Sogha Khawari2, Anand Pandit2

  • 1University College London University, London, UK. francesco.magni.16@ucl.ac.uk.

Acta Neurochirurgica
|September 11, 2023
PubMed
Summary
This summary is machine-generated.

Intracranial pressure monitoring reveals an initial pressure spike after dural breach, decreasing significantly within 20 minutes. This finding is crucial for interpreting intracranial pressure readings accurately.

Keywords:
ICM+Intracranial pressureIntracranial pressure monitoring

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Area of Science:

  • Neurosurgery
  • Neurology
  • Critical Care Medicine

Background:

  • Intraparenchymal intracranial pressure (ICP) monitoring is essential for diagnosing hydrocephalus and cerebrospinal fluid disorders.
  • Immediate ICP changes post-dural breach are not well-documented.

Purpose of the Study:

  • To investigate ICP dynamics in the period directly following dural breach during elective ICP monitoring.

Main Methods:

  • Prospective cohort study of 10 patients undergoing elective ICP monitoring.
  • ICP readings recorded at opening and every 5 minutes for 30 minutes post-insertion.

Main Results:

  • A significant decrease in ICP was observed every 5 minutes, with a total reduction of 15.2 mmHg at 20 minutes (p < 0.0001).
  • An initial ICP 'spike' phenomenon was identified, averaging 15.2 mmHg higher than the plateau reached at 20 minutes.

Conclusions:

  • The study identified a transient ICP spike post-dural breach, which stabilizes by 20 minutes.
  • Findings guide the interpretation of ICP monitoring data and suggest potential influences of sedation and pain response.