Long-term intracranial pressure recording in the management of pseudotumor cerebri

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Abstract
Long-term monitoring of intracranial pressure (ICP) was used as an aid for the management of 4 patients with pseudotumor cerebri. After the implantation of a small experimental pressure sensor in the skull, most of the subsequent ICP measurements were made noninvasively by an external interrogator. During the initial study of the patient, baseline ICP recordings were made in the hospital before treatment. Pressure recordings of a 24 h basis were continued during treatment, which, depending on the case, was with Diamox (acetazolamide), steroids or thecoperitoneal shunting. After discharge these patients returned weekly over 10-22 mo. for ICP measurement and for ophthalmological examination. ICP before treatment showed irregular variations ranging from 100-500 mm H2O over a 24 h period. The efficacy of treatments could be assessed in a few hours by the degree of ICP stabilization. Shunt malfunction was detected by a slow but continuous rise in pressure before full clinical signs were evident.

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