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CC BY-NC-ND 4.0 · Asian J Neurosurg 2024; 19(03): 402-407
DOI: 10.1055/s-0044-1787536
Original Article

Intracranial Pressure Monitoring Location: A Pilot Study on the Validation of Subdural Site with the Intraventricular Site

Suparna Bharadwaj
1   Department of Neuro Anaesthesia and Neuro Critical Care, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
,
Mouleeswaran Sundaram
1   Department of Neuro Anaesthesia and Neuro Critical Care, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
,
Dhritiman Chakrabarti
1   Department of Neuro Anaesthesia and Neuro Critical Care, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
,
Radhakrishnan Muthuchellappan
1   Department of Neuro Anaesthesia and Neuro Critical Care, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
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Abstract

Introduction Knowledge of preoperative and intraoperative intracranial pressure (ICP) enables the neuroanesthesiologist to optimize cerebral perfusion pressure. However, ICP is rarely monitored during the intraoperative period. In this report, subdural site ICP measurement is validated with intraventricular ICP measurement, and the feasibility of subdural ICP monitoring during the intraoperative period is discussed.

Materials and Methods In this prospective pilot study, ICP measurement at the subdural site was achieved with an intravenous cannula and the ventricular site with a ventricular cannula. Both were transduced using a fluid-filled pressure transducer and connected to the monitor for display of the number and the waveforms. Monitoring of intraoperative ICP using both the techniques was done in all patients recruited into the study. The correlation between the two modalities of measurement was studied by the Spearman correlation test and their limits of agreement were studied using the Bland–Altman plot. A case series describing the perioperative management based on the subdural ICP values are also described.

Results Subdural ICP showed a strong correlation with intraventricular ICP (r s = 0.93, p = 0.01). Agreement analysis using the Bland–Altman plot showed that the mean difference of ICP between the modalities was 1.44 mm Hg (95% confidence interval, −0.6 to 3.49, p = 0.122).

Discussion This study validates the ICP values measured at the subdural site with the intraventricular site. Subdural site ICP monitoring can be achieved rapidly with readily available systems and helps in making intraoperative clinical decisions.

Conclusion Cannula-based subdural ICP is a satisfactory alternative to intraventricular ICP monitoring in the intraoperative period.

Keywords

intraoperative intracranial pressure monitoring - intraventricular catheter - subdural catheter - perioperative management

Authors' Contributions

S.B. was responsible for the conceptualization, methodology, and manuscript preparation. M.S. handled data collection, while D.C. focused on data analysis. R.M. provided supervision and was involved in manuscript preparation, reviewing, and editing. All authors reviewed the results and approved the final version of the manuscript.




Publication History

Article published online:
18 June 2024

© 2024. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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