Assessment of Childhood Intracranial Pressure Recordings Using a New Method of Processing Intracranial Pressure Signals

Abstract

Background: Intracranial compliance may be more reliably predicted by the pulsatile component (pulse pressure) than the steady (mean pressure) component of intracranial pressure (ICP). A new method of processing continuous ICP signals assessing both components of ICP is described and applied to the ICP recordings of 6 pediatric cases. Method: The new method was applied to each subsequent 6-second time sequence window of a continuous ICP signal. For time sequence windows including single ICP waves, the following time sequence (TS.x)-related parameters were computed: (a) mean ICP (i.e. TS.MeanP) was computed according to the currently used and known technology; (b) the mean ICP wave was computed according to the new method, characterized by mean wave amplitude (i.e. TS.MeanWavedP) and mean wave latency (i.e. TS.MeanWavedT). Cases No. 1–4 were treated for hydrocephalus and cases No. 5 and 6 for craniosynostosis. Results: In 5 children, clinical intracranial hypertension was associated with elevations of mean ICP above 15–20 mm Hg of variable durations. The ICP recordings of the 5 children with intracranial hypertension and successful outcome after surgery revealed mean wave amplitude values above 5 mm Hg. Mean wave latency was more variable, ranging between 0.10 and 0.25 s. Conclusions: In the children with intracranial hypertension and successful outcome after surgery, mean wave amplitude was variably above 5 mm Hg. It is suggested that mean wave amplitude may be a useful parameter by more directly predicting cerebral compliance than mean ICP.