Continuous intracranial pressure monitoring in pseudotumour cerebri: Single centre experience

Abstract

Objective. Investigating pseudotumour cerebri (PTC) patients who do not fulfil the diagnostic criteria, or those presenting post-shunt insertion with recurrent symptoms and signs, with no clear evidence of shunt malfunction, present a diagnostic challenge. PTC patients who underwent continuous intracranial pressure (ICP) monitoring in our unit were reviewed retrospectively.

Results. Twenty-six ICP monitoring procedures were done on 20 patients. Eleven patients had normal pressure, 2 overdrainage/low pressure, 11 underdrainage/high pressure and 2 variable pressures. On the basis of these results 12 patients were managed conservatively: 11 patients were referred to headache team and 1 patient had readjustment of an adjustable valve shunt setting; of those 3 patients had improved symptoms on their first post-operative clinic review. On the other hand, 14 patients had surgery: 5 had shunt revision and 9 had shunt insertion; of those 5 patients improved.

Conclusion. ICP monitoring using an intraparenchymal probe is a safe and effective diagnostic technique in investigating PTC when indicated. A multidisciplinary approach achieves best results in terms of successful management and follow-up.

Key words:

• Idiopathic intracranial hypertension
• benign intracranial hypertension
• pseudotumour cerebri
• intracranial pressure monitoring
• lumboperitoneal shunt

Declaration of interest: Clinical research fellow post at the Victor Horsley Department of Neurosurgery (Mr. Toma and Mr. Tarnaris) is supported by a grant from B. Braun/Aesculap.