Clinical and radiological findings in long-term intracranial pressure monitoring

Abstract

Advantages of telemetric devices for long-term intracranial pressure (ICP) measurement have been mentioned several times in the literature. However, descriptions of associated complications are lacking. Therefore, the presented observational study focused on clinical and radiological findings after insertion of an intraparenchymal telemetric ICP monitor. Between April 2010 and February 2013, 185 telemetric ICP catheters were implanted for diagnostic purposes. All patients were clinically followed. Radiological, microbiological and clinical data were analysed. One brain abscess (0.5%) and two cutaneous infections (1.1%) occurred in 185 patients. Staphylococcus spp. could be detected in all cases. Six patients (3.2%) suffered from single new-onset seizures and one patient (0.5%) from a temporary hemiparesis. Intracerebral haemorrhages occurred in 15.6%, most of the time as small punctate bleedings. Perifocal oedematous reactions surrounding inserted telemetric catheters could be observed in 46.9%. Multiple imaging studies revealed a tendency of complete oedema resolution over time. Infectious as well as haemorrhagic complication rates are well comparable with the common literature. The long-term implantation of an ICP probe does not seem to increase the risk of wound infections or brain abscess formation. Surprisingly, very high numbers of oedematous reactions after insertion of the intraparenchymal ICP monitor were seen. Reasons therefore could only be speculated upon.