Interpretation of telemetric intracranial pressure recordings in people with idiopathic intracranial hypertension after shunt implantation

A Neuro-Ophthalmologist’s Guide to Advances in Intracranial Pressure Measurements

“…Fluctuations in the pulsatile ICP also occur with postural changes, with higher values observed in the upright compared to the supine position. 19 , 34 , 37 It is challenging to explain this observation from the mechanistic perspective given that compliance is considered lower in the supine position, and fine volume-pressure regulations at the glia–neuro-vascular interface may be of particular significance here. 38 …”

“… 68 This leads in one neuroscience centre to an opportunity to evaluate the M.scio telesensor (Aesculap-Miethke, Germany) in a large cohort of people with idiopathic intracranial hypertension requiring surgery for sight threatening papilloedema. 37 In the cohort of fifty-seven people, 37 had the proGAV2.0 set at 15 cmH 2 O and 20 had the proGAV2.0 set at 10 cmH 2 O. The average value of mean sitting ICP was −2.7 mmHg versus −5.6 mmHg (p = 0.08), and mean supine ICP was 18.4 mmHg versus 12.9 mmHg (p = 0.001) at the valve settings of 15 cmH 2 O versus 10 cmH 2 O, respectively.…”

“…A possible explanation of the absence of pulsatility in patent shunts is intermittent collapse of the ventricular wall on the catheter. 37

Figure 4 ICP curves (10 seconds recordings) with the M.scio system in five people with idiopathic intracranial hypertension and a ventriculoperitoneal shunt. ICP is plotted on the Y-axis (mmHg) and time on X-axis (seconds).

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