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Robert H. Rosenwasser, Laurence I. Kleiner, Joseph P. Krzeminski, and William A. Buchheit

: 494 – 519 , 1976 Rosner MJ, Becker DP: ICP monitoring: complications and associated factors. Clin Neurosurg 23: 494–519, 1976 8. Saul TG , Ducker TB : Effect of intracranial pressure monitoring and aggressive treatment on mortality in severe head injury. J Neurosurg 56 : 498 – 503 , 1982 Saul TG, Ducker TB: Effect of intracranial pressure monitoring and aggressive treatment on mortality in severe head injury. J Neurosurg 56: 498–503, 1982 9. Silverberg GD : Intracranial pressure monitoring , in

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Intracranial pressure monitoring after elective intracranial surgery

A retrospective study of 514 consecutive patients

Shlomi Constantini, Shamay Cotev, Z. Harry Rappaport, Shlomo Pomeranz, and Mordechai N. Shalit

acknowledge the thoughtful advice of Prof. A. Beller in reviewing the manuscript. References 1. Johnston IH , Jennett B : The place of continuous intracranial pressure monitoring in neurosurgical practice. Acta Neurochir 29 : 53 – 63 , 1973 Johnston IH, Jennett B: The place of continuous intracranial pressure monitoring in neurosurgical practice. Acta Neurochir 29: 53–63, 1973 2. Kaye AH , Brownbill D : Postoperative intracranial pressure in patients operated on for cerebral aneurysms following

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J. Stuart Crutchfield, Raj K. Narayan, Claudia S. Robertson, and Lloyd H. Michael

pressure: a review of clinical problems, measurement techniques and monitoring methods. J Med Eng Technol 10: 299–320, 1986 2. Aucoin PJ , Kotilainen HR , Gantz NM , et al : Intracranial pressure monitors. Epidemiologic study of risk factors and infections. Am J Med 80 : 369 – 376 , 1986 Aucoin PJ, Kotilainen HR, Gantz NM, et al: Intracranial pressure monitors. Epidemiologic study of risk factors and infections. Am J Med 80: 369–376, 1986 3. Barlow P , Mendelow AD , Lawrence AE , et al

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Gordon G. Stuart, Glen S. Merry, James A. Smith, and John D. N. Yelland

evacuation of hematomas. Bone plates were usually replaced and extensive decompression procedures were not used. When a patient in a country hospital is deteriorating too rapidly to permit safe transfer, our policy is to advise exploratory burr holes and evacuation of surface hematomas prior to transfer. Intracranial pressure monitoring was not carried out in this series. Assisted ventilation was used in 43 patients to provide optimal oxygenation of neurons rather than as a means of reducing ICP. Tracheostomy was performed in patients who required endotracheal tubes for

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Brendan F. Judy, Jordan W. Swanson, Wuyang Yang, Phillip B. Storm, Scott P. Bartlett, Jesse A. Taylor, Gregory G. Heuer, and Shih-Shan Lang

Neurosurg 35 : 195 – 204 , 2001 11694797 10.1159/000050421 8 Gambardella G , Zaccone C , Cardia E , Tomasello F : Intracranial pressure monitoring in children: comparison of external ventricular device with the fiberoptic system . Childs Nerv Syst 9 : 470 – 473 , 1993 10.1007/BF00393552 8124675 9 Gault DT , Renier D , Marchac D , Ackland FM , Jones BM : Intracranial volume in children with craniosynostosis . J Craniofac Surg 1 : 1 – 3 , 1990 2088558 10.1097/00001665-199001000-00003 10 Gault DT , Renier D , Marchac D , Jones

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Richard C. E. Anderson, Peter Kan, Paul Klimo, Douglas L. Brockmeyer, Marion L. Walker, and John R. W. Kestle

children with TBI, it seems reasonable to consider a fiberoptic device first unless there are compelling reasons for immediate ventricular drainage. Although the majority of these complications were clinically insignificant, surgeons should be aware of these different complication rates when choosing the most appropriate device for each patient. References 1. Aucoin PJ , Kotilainen HR , Gantz NM , et al : Intracranial pressure monitors. Epidemiologic study of risk factors and infections. Am J Med 80 : 369 – 376 , 1986

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Samon Tavakoli, Geoffrey Peitz, William Ares, Shaheryar Hafeez, and Ramesh Grandhi

, Zhang L , McBee N , Kase C , : Bleeding and infection with external ventricular drainage: a systematic review in comparison with adjudicated adverse events in the ongoing Clot Lysis Evaluating Accelerated Resolution of Intraventricular Hemorrhage Phase III (CLEAR-III IHV) trial . Neurosurgery 76 : 291 – 301 , 2015 25635887 10.1227/NEU.0000000000000624 16 Dimitriou J , Levivier M , Gugliotta M : Comparison of complications in patients receiving different types of intracranial pressure monitoring: a retrospective study in a single center in

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Neurosurgical Forum: Letters to the editor To The Editor Zeev Feldman , M.D. , Eli Reichenthal , M.D. Soroka Medical Center Beer-Sheba, Israel 329 330 We read with great interest the article by O'Sullivan, et al. (O'Sullivan MG, Statham PF, Jones PA, et al: Role of intracranial pressure monitoring in severely head-injured patients without signs of intracranial hypertension on initial computerized tomography. J Neurosurg 80: 46–50, January, 1994). The authors concluded that, as seven of eight patients

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Morten Andresen, Marianne Juhler, and Ole Cornelius Thomsen

Object

Intracranial pressure (ICP) monitoring is used extensively in clinical practice, and as such, the accuracy of registered ICP values is paramount. Clinical observations of nonphysiological changes in ICP have called into question the accuracy of registered ICP values. Subsequently, the authors have tried to determine if the ICP monitors from major manufacturers were affected by electrostatic discharges (ESDs), if the changes were permanent or transient in nature, and if the changes were modified by the addition of different electrical appliances normally used in the neurointensive care unit environment.

Methods

The authors established a test setup in the neurointensive care unit using a large container filled with isotonic saline, creating a phantom patient. Intracranial pressure monitors were sequentially lowered into the container and subjected to a predefined test battery of ESDs.

Results

Five pressure monitors from 4 manufacturers were evaluated. Three monitors containing electrical circuitry at the tip of the transducer were all affected by ESDs. Clinically significant permanent changes in the reported ICP values for 1 pressure monitor were observed, as well as temporary deflections for 2 other monitors. The monitors had different levels of sensitivity to discharges at low voltages.

Conclusions

These results explain some of the sudden shifts in ICP noted in the clinical setting. However, a clear deflection pattern related to the addition of electrical appliances was not found. The authors recommend instituting policies for reducing the risk of subjecting patients to ESDs in the neurointensive care unit setting.

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Dale Ding, Robert M. Starke, Christopher R. Durst, R. Webster Crowley, and Kenneth C. Liu

Increasing evidence supports dural venous sinus stenosis as the patho-etiology of pseudotumor cerebri (PTC) in a subset of affected patients. In this video, we demonstrate our technique for 1) diagnostic venous manometry to identify a flow-limiting stenosis of the transverse sinus in a PTC patient; and 2) successful treatment of the patient with venous stenting across the structural and physiological stricture in the dural sinus. The pressure gradient decreased from 20 mmHg pre-stent to 3 mmHg post-stent. In order to further quantify the effect of our intervention, concurrent intracranial pressure monitoring was performed.

The video can be found here: http://youtu.be/auxRg17F8yI.