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. 2023 Jun;165(6):1523-1531.
doi: 10.1007/s00701-023-05572-z. Epub 2023 Apr 18.

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

Fardad T Afshari  1 , Mahmoud Samara  1 , Kyaw Zayar Thant  1 , Marian E Byrne  1 , Alexandra J Sinclair  2   3 , Susan P Mollan  2   4 , Georgios Tsermoulas  5   6
Affiliations

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

Fardad T Afshari et al. Acta Neurochir (Wien). 2023 Jun.

Abstract

Background: The M.scio telesensor (Aesculap-Miethke, Germany) is a device integrated within a ventriculoperitoneal (VP) shunt for non-invasive measurement of the intracranial pressure (ICP). The purpose of this study was to analyze the telemetric recordings with the M.scio system in shunted patients with idiopathic intracranial hypertension (IIH), in order to determine reference values and assist the interpretation of telemetric data.

Methods: This was a cohort study of consecutive patients with fulminant IIH who underwent primary VP shunt insertion between July 2019 and June 2022. The first telemetric measurements after surgery in the sitting and supine positions were analyzed. Telemetric ICP values, wave morphology, and pulse amplitude were determined for functioning and malfunctioning shunts.

Results: Fifty-seven out of 64 patients had available telemetric recordings. The mean ICP was - 3.8 mmHg (standard deviation (SD) = 5.9) in the sitting and 16.4 mmHg (SD = 6.3) in the supine position. The ICP curve demonstrated pulsatility in 49 (86%) patients. A pulsatile curve with mean ICP in the above ranges indicated a functioning shunt, whereas the lack of pulsatility was challenging to interpret. There was a significant positive correlation between ICP versus amplitude, ICP versus body mass index (BMI), and amplitude versus BMI.

Conclusions: This clinical study defined ICP values and curves in IIH patients with a shunt. The results will assist the interpretation of telemetric ICP recordings in clinical decision making. More research is required to model longitudinal recordings and explore the link between telemetric measurements with clinical outcomes.

Keywords: Cerebrospinal fluid; Idiopathic intracranial hypertension; Intracranial pressure; M.scio; Pseudotumour cerebri; Telesensor.

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