Assessment of childhood intracranial pressure recordings using a new method of processing intracranial pressure signals

Background: Intracranial compliance may be more reliably predicted by the pulsatile component (pulse pressure) than the steady (mean pressure) component of intracranial pressure (ICP). A new method of processing continuous ICP signals assessing both components of ICP is described and applied to the ICP recordings of 6 pediatric cases. Method: The new method was applied to each subsequent 6-second time sequence window of a continuous ICP signal. For time sequence windows including single ICP waves, the following time sequence (TS.x)-related parameters were computed: (a) mean ICP (i.e. TS.MeanP) was computed according to the currently used and known technology; (b) the mean ICP wave was computed according to the new method, characterized by mean wave amplitude (i.e. TS.MeanWavedP) and mean wave latency (i.e. TS.MeanWavedT). Cases No. 1 4 were treated for hydrocephalus and cases No. 5 and 6 for craniosynostosis. Results: In 5 children, clinical intracranial hypertension was associated with elevations of mean ICP above 15-20 mm Hg of variable durations. The ICP recordings of the 5 children with intracranial hypertension and successful outcome after surgery revealed mean wave amplitude values above 5 mm Hg. Mean wave latency was more variable, ranging between 0.10 and 0.25 s. Conclusions: In the children with intracranial hypertension and successful outcome after surgery, mean wave amplitude was variably above 5 mm Hg. It is suggested that mean wave amplitude may be a useful parameter by more directly predicting cerebral compliance than mean ICP. Copyright (c) 2005 S. Karger AG, Basel.