Turkish Neurosurgery
Analysis of intracranial compliance through noninvasive intracranial pressure waveforms in hydrocephalus patients. A pilot study.
Raphael Bertani1, Stefan W Koester2, Caio Perret3, Paulo Santa Maria3, Sérgio Brasil4, Gustavo Frigieri5, Sávio Batista6, Nicolas Nunes Rabello4, Ruy Monteiro3
1University of São Paulo, Department of Neurosurgery, São Paulo,
2Vanderbilt University, School of Medicine, Nashville, TN,
3Hospital Municipal Miguel Couto, Department of Neurosurgery, Rio de Janeiro, RJ,
4University of São Paulo, Department of Neurology, São Paulo,
5University of São Paulo, School of Medicine, São Paulo,
6Federal University of Rio de Janeiro, Faculty of Medicine, Rio de Janeiro,
DOI: 10.5137/1019-5149.JTN.45668-23.2
Aim:To assess the changes of intracranial pressure waveforms (ICPW) acquired noninvasively in a set of acute hydrocephalus patients prior to and posterior to interventions.Material and Methods:Patients with clinical and radiological diagnoses of hydrocephalus were evaluated for alterations in ICPW by means of a system that detects cranial micro expansions just before and immediately after interventions. The system quantified the difference between ICPW peaks (P1 and P2), providing the P2/P1 ratio. Results:Fourteen patients aged from 26 to 73 years old were included. Hydrocephalus etiologies were normal pressure hydrocephalus, post-traumatic and all patients had an abnormal intracranial compliance waveform, with P2>P1 before the procedure (5 external ventricle drains (EVD) and 9 ventriculoperitoneal shunts (VPS). Immediately after, 75% of the patients changed to a standard pattern with P1>P2.Conclusion:In this exploratory study using a novel noninvasive technique, rapid cerebrospinal fluid drainage by means of EVD and VPS was effectively assessed and had a positive impact on intracranial compliance.
Corresponding author : Sávio Batista