Document Detail


Is intracranial pressure monitoring in the epidural space reliable? Fact and fiction.
MedLine Citation:
PMID:  17432703     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: Epidural pressures have been reported as being systematically higher than ventricular fluid pressures. These discrepancies have been attributed both to the characteristics of the sensor and to the particular anatomy of the epidural space. To determine which of these two possible causes better explains higher epidural readings, the authors compared pressure values obtained during simultaneous epidural and lumbar pressure monitoring in 53 patients and during simultaneous subdural and lumbar pressure monitoring in 22 patients. The same nonfluid coupled sensor device was used in all compartments. METHODS: All 75 patients had normal craniospinal communication. Simultaneous intracranial and lumbar readings were performed every 30 seconds. The epidural-lumbar and subdural-lumbar pressure values were compared using correlation analysis and the Bland-Altman method. The median differences in initial epidural-lumbar and subdural-lumbar pressure values were 11 mm Hg (interquartile range 2-24 mm Hg) and 0 mm Hg (interquartile range -2 to 1 mm Hg), respectively. The correlation coefficients of the mean epidural-lumbar and subdural-lumbar intracranial pressure (ICP) values were p = 0.48 (p < 0.001) and p = 0.88 (p < 0.001), respectively. Using the Bland-Altman analysis, epidural-lumbar methods showed a mean difference of -20.93 mm Hg; epidural pressure values were systematically higher than lumbar values, and these discrepancies were greater with higher ICP values. Subdural-lumbar methods showed a mean difference of 0.35 mm Hg and both were equally valid with all mean ICP values. CONCLUSIONS: Epidural ICP monitoring produces artifactually high values. These values are not related to the type of sensor used but to the specific characteristics of the epidural intracranial space.
Authors:
Maria Antonia Poca; Juan Sahuquillo; Thomaz Topczewski; Maria Jesús Peñarrubia; Asunción Muns
Related Documents :
16103043 - Critical thresholds of intracranial pressure and cerebral perfusion pressure related to...
9088823 - The effect of alfentanil on cerebrospinal fluid pressure in human volunteers.
10806183 - Detection of positional airway obstruction in neonates by acoustic reflection.
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  106     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-04-16     Completed Date:  2007-05-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  548-56     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurosurgery, Vall d'Hebron University Hospital, Autonomous University of Barcelona, Spain. 26382app@comb.es
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Electrodes, Implanted
Epidural Space / physiopathology*
Female
Humans
Intracranial Hypertension / physiopathology*
Intracranial Pressure / physiology*
Lumbosacral Region
Male
Middle Aged
Monitoring, Physiologic / methods*
Prospective Studies
Reproducibility of Results
Subarachnoid Space / physiopathology*
Subdural Space / physiopathology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Sex and genetic associations with cerebrospinal fluid dopamine and metabolite production after sever...
Next Document:  Evaluation of intraaxial enhancing brain tumors on magnetic resonance imaging: intraindividual cross...