Skip to main content
Log in

A comparison of extradural and intraparenchymatous intracranial pressures in head injured patients

  • Brief Report
  • Published:
Intensive Care Medicine Aims and scope Submit manuscript

Abstract

The reliability of extradural pressure measurements for the measure of intracranial pressure (ICP) is still controversial. This study was undertaken to assess the limits of agreement between extradural and intraparenchymatous pressures using respectively the Plastimed extradural sensor and the Camino fiberoptic system. The study took place in a neurosurgical intensive care unit. Ten head injured patients were included in the study, leading to the comparison of 1032 pairs of hourly ICP values. Although the measures were significantly correlated, there was no agreement between the two methods of ICP monitoring. Extradural pressure was higher than intraparenchymatous pressure (bias 9 mmHg; 95% confidence interval of bias-9.8 to 27.8 mmHg). The lack of agreement between the two methods is probably due to the unreliability of extradural pressure for the measurement of ICP.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

References

  1. Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet I:307–310

    Google Scholar 

  2. Narayan RK, Kishore PRS, Becker DP, Ward JD, Enas GG, Greenberg RP, Da Silva AD, Lipper MH, Choi SC, Mayhall CG, Lutz HA, Young HF (1982) Intracranial pressure: to monitor or not to monitor? J Neurosurg 56:650–659

    PubMed  Google Scholar 

  3. Weaver DD, Winn HR, Jane JA (1982) Differential intracranial pressure in patients with unilateral mass lesions. J Neurosurg 56:660–665

    PubMed  Google Scholar 

  4. Gambardella G, D'Avella D, Staropoli C, Toscano S, Tomasello F (1993) Bilateral intraparenchymal pressure in patients with unilateral supratentorial mass lesions. In: A Avezaat CJJ, Eijndhoven JHM, Maas AIR, Tans JTJ (eds) Intracranial pressure VIII. Springer, Berlin, pp 82–84

    Google Scholar 

  5. Yano M, Ikeda Y, Kobayashi S, Otsuka T (1985) Intracranial pressure in head-injured patients with various intracranial lesions is identical throughout the supratentorial intracranial compartment. Neurosurgery 21:688–692

    Google Scholar 

  6. Powell MP, Crockard HA (1985) Behavior of an extradural pressure monitor in clinical use. J Neurosurg 63:745–749

    PubMed  Google Scholar 

  7. Poon WS, Li AKC (1990) Accuracy of different routes of intracranial pressure (ICP) monitoring using microtransducers. J Neurosurg Anesth 2:280–283

    Google Scholar 

  8. Crutchfield JS, Narayan RK, Robertson CS, Michael LH (1990) Evaluation of a fiberoptic intracranial pressure monitor. J Neurosurg 72:482–487

    PubMed  Google Scholar 

  9. Chambers IR, Kane PJ, Choksey MS, Mendelow AD (1993) An evaluation of the Camino ventricular bolt system in clinical practice. Neurosurg 33:866–868

    Google Scholar 

  10. Sundbärg G, Nordström CH, Messeter K, Söderström S (1987) A comparison of intraparenchymatous and intraventricular pressure recording in clinical practice. J Neurosurg 67:841–845

    PubMed  Google Scholar 

  11. Statham P, Midgley S, Dearden NM, McIntosh C, Miller JD (1993) A clinical evaluation of an intraparenchymal intracranial pressure transducer. In: Avezaat CJJ, Eijndhoven JHM, Maas AIR, Tans JTJ (eds) Intracranial pressure VIII. Springer, Berlin, pp 7–10

    Google Scholar 

  12. Piek J, Bock WJ (1990) Continuous monitoring of cerebral tissue pressure in neurosurgical practice. Experience with 100 patients. Intensive Care Med 16:184–188

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bruder, N., N'Zoghe, P., Graziani, N. et al. A comparison of extradural and intraparenchymatous intracranial pressures in head injured patients. Intensive Care Med 21, 850–852 (1995). https://doi.org/10.1007/BF01700971

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01700971

Key words

Navigation