Recording Of Ventricular Fluid Pressure Research Articles

Complications due to prolonged ventricular fluid pressure recording.

All complications in a consecutive series of 648 patients subjected to prolonged recording of the ventricular fluid pressure (VFP) during 1982-1986 were registered and analysed. The procedure did not cause permanent symptoms or deficits in any case except for one haemorrhagic complication. Definite infections caused by the VFP recording were found in 4.3% of the 540 patients (83%) surviving their disease or lesion, and in 1.9% in non-survivors. These infections were almost exclusively registered in patients treated with prolonged drainage of hemorrhagic ventricular fluid, while definite infections in other patients were found in only 1.3%. Most infections were caused by Staphylococcus epidermidis and all infections could be treated successfully. Infection did not cause or contribute to the lethal outcome in any case. In 60% of the cases with infectious complications laboratory signs of ventriculitis occurred after a surgical revision of the ventriculostomy. The duration of VFP recording was of subordinate importance for the development of infection. In 13 patients (1.9%) during the studied period a reliable VFP recording was not obtained, a fact that points to the need for alternative methods in a minority of patients with elevated intracranial pressure. It is concluded that complications caused by VFP recording can be kept at an acceptably low frequency in patients without haemorrhagic cerebrospinal fluid demanding long-term drainage.

Comparison of ventricular steady-state infusion with bolus infusion and pressure recording for differentiating between arrested and non-arrested hydrocephalus

In 6 years 26 adult patients with chronic communicating or non-communicating hydrocephalus underwent ventricular fluid pressure (VFP) recording, including intraventricular steady-state and bolus infusion tests. Patients were treated with a shunt when steady-state infusion yielded a csf outflow resistance (Rcsfs) greater than 10 mm Hg/ml/min; the success rate was 83%. The main purpose of the study was to compare Rcsfs with outflow resistance obtained by bolus infusions (Rcsfb), pressure-volume index (PVI) and VFP. Rcsfs was higher than Rcsfb, particularly when resistance was high and the degree of disturbance of csf dynamics was reflected by Rcsfs better than by Rcsfb. The PVI showed a roughly inverse relationship with the Rcsfs but was not helpful in differentiating arrested from non-arrested hydrocephalus. Rcsfs and VFP correlated better than expected. A high Rcsfs was associated with an elevated VFP and a normal Rcsfs with a normal VFP. VFP only varied when Rcsfs exhibited a mild to moderate increase. It is concluded that steady-state infusion remains the most reliable method for the prediction of the result of shunting. We recommend shunting when Rcsfs is greater than 10 mm Hg/ml/min. Bolus infusions provide valuable data on brain elastance and additional information on csf outflow resistance. VFP recording is certainly worthwhile because infusion tests can be omitted when VFP is clearly elevated and useful information is obtained when Rcsf is borderline.

Ventricular fluid pressure recording after severe brain injuries.

This paper surveys the results obtained by continuous ventricular fluid pressure recording in severe brain injuries. Ventricular fluid pressure recording should be used when there is a clear-cut indic

Lack of correlation between ventricular fluid pressure and arterial blood pressure in severe brain injuries.

In ten patients with severe brain injury, arterial blood pressure was recorded continuously by means of an arterial catheter, concomitantly with a recording of ventricular fluid pressure by means of a catheter in one lateral ventricle. The purpose of the study was to test whether there was a correlation between blood pressure and intracranial pressure. There was no consistent correlation. Intracranial pressure cannot be gauged from arterial blood pressure recordings, and it seems futile to monitor arterial blood pressure continuously in brain injured patients. Only when the brain was already dead or dying was there a reliable correlation between arterial blood pressure and ventricular fluid pressure.