[Intracranial pressure recording. Principles, technics, results and possibilities]

Methods for continuous ICP recording were further developed. Intraventricular pressure measurement requires puncture of the brain, and is susceptible to infection. For routine applications, therefore, preferential use is made of miniaturized pressure transducers which, without the need to open the dura, are simply implanted epidurally. In the absence of disorders of blood clotting, no complications, in particular no infections, were observed in more than 900 measurements. In the case of rapidly growing intracranial space-consuming processes, considerable intracranial pressure differences giving rise to intracranial mass shifts and even incarceration occur. These pressure gradients can also be measured and treated clinically. The pathological intracranial pressure curve shows typical wave dynamics with A, B, C and D waves, and pulsation changes. In intensive care, measurement permits rapid detection of complications, selective treatment and prognostic information, including the temporal definition of brain death. In neurological and neuropediatric diagnosis, ICP measurement differentiates between active hydrocephalus and cerebral atrophy/dystrophy, and here, as also in cystic cerebral changes, subdural effusions, etc., helps clarify the indication for surgery. In the case of "pseudo tumour cerebri", too, ICP measurement permits objectivation. In addition, it is also possible to determine directly the intracranial reserve space and the CSF dynamics (bolus/infusion test, pulse wave analysis).