Telemetric intracranial pressure monitoring: our experience with 22 patients investigated for intracranial hypertension

Introduction We present the application of the Raumedic(R) P-tel telemetric device that monitors Intracranial Pressure (ICP) over long periods, in 22 patients, with suspected intracranial hypertension. Methods A telemetric device (Raumedic(R), Neurovent(R) P-tel) was surgically implanted in 22 patients aged between 21 and 65 years. Among the patients, the inconclusive diagnosis of benign intracranial hypertension was set in 10, the possible diagnosis of postoperative hydrocephalus in 3, and the possible diagnosis of aqueduct stenosis in 2. Additionally, shunt malfunction and Normal Pressure Hydrocephalus (NPH) were investigated in 1 and 3 patients, respectively. Finally, 3 patients presented ventricular dilatation of unknown origin. All the individuals underwent a 3-day ICP recording within the nursing unit. Three more recordings were obtained over a period of 2-6 months at the outpatient base. Results Analysis of the data excluded the diagnosis of intracranial hypertension in 12 patients. Elevated ICP values were confirmed in 10 patients. Subsequently, 7 of them underwent shunts' implantation, while 2 refused further neurosurgical treatment and 1 was treated with acetazolamide. Additionally, 1 patient who demonstrated normal ICP values, thus confirmed with NPH, underwent VP shunt implantation, while another 2 with similar characteristics refused further surgery. In our series the overall clinical complication rate after P-tel implantation was insignificant. Conclusions The telemetric device is safely implanted via a rather simple procedure. In selected patients, it could provide long-term ICP recordings, which are necessary to confirm diagnosis and guide to the appropriate treatment.