Analysis of Intracranial Compliance Through Noninvasive Intracranial Pressure Waveforms in Hydrocephalus Patients. A Pilot Study.

Abstract

Aim: To assess the changes of intracranial pressure waveforms (ICPW) acquired noninvasively in a set of acute hydrocephalus patients prior to and posterior to interventions.

Material and methods: Patients with clinical and radiological diagnosis of hydrocephalus were evaluated for alterations in ICPW by means of a system that detects cranial micro expansions just before and immediately after interventions. The system quantified the difference between ICPW peaks (P1 and P2), providing the P2/P1 ratio.

Results: Fourteen patients aged from 26 to 73 years old met the inclusion criteria. Hydrocephalus etiologies were normal pressure hydrocephalus, post-traumatic and all patients had an abnormal intracranial compliance waveform, with P2 > P1 before the procedure (5 external ventricular drains (EVD) and 9 ventriculoperitoneal shunts (VPS). Immediately after, 75% of the patients changed to a standard pattern with P1 > P2.

Conclusion: In this exploratory study using a novel noninvasive technique, rapid cerebrospinal fluid drainage by means of EVD and VPS was effectively assessed and had a positive impact on intracranial compliance.