Complications of intracranial pressure monitoring in children with head trauma

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Publication Type Journal Article
School or College School of Medicine
Department Neurosurgery
Creator Kestle, John R. W.; Brockmeyer, Douglas Lee
Other Author Anderson, Richard C. E.; Kan, Peter; Klimo, Paul; Walker, Marion L.
Title Complications of intracranial pressure monitoring in children with head trauma
Date 2004
Description Object. Intracranial pressure (ICP) monitoring has become routine in the management of patients with traumatic brain injury (TBI). Many surgeons prefer to use external ventricular drains (EVDs) over fiberoptic monitors to measure ICP because of the added benefit of cerebrospinal fluid drainage. The purpose of this study was to examine a consecutive series of children with TBI and compare the incidence of complications after placement of an EVD, a fiberoptic intraparencyhmal monitor, or both. Methods. A retrospective chart review was conducted to identify children with TBI who met the criteria for insertion of an ICP monitor. All patients underwent head CT scanning on admission and after placement of an ICP monitor. During a 5-year period 80 children met the criteria for inclusion in the study. Eighteen children (22.5%) underwent EVD placement only, 18 (22.5%) underwent placement of a fiberoptic device only, and 44 (55%) received both. A total of 62 fiberoptic devices (48%) were inserted, and 68 EVDs (52%) were placed. Overall, there was a fourfold increased risk of complications in children who received an EVD compared with those in whom a fiberoptic monitor was placed (p = 0.004). Hemorrhagic complications were detected in 12 (17.6%) of 62 patients who received an EVD compared with four (6.5%) of 62 patients who received a fiberoptic monitor (p = 0.025). Six (8.8%) of 68 EVDs were malpositioned and required replacement; in three (50%) of these cases a hemorrhagic complication occurred. Only one infection was noted in a patient with an EVD (1.5%). Conclusions. In this retrospective cohort of pediatric patients with TBI, complication rates were significantly higher in those receiving EVDs than in those in whom fiberoptic monitors were placed. Although the majority of these complications did not entail clinical sequelae, surgeons should be aware of the different complication rates when choosing the most appropriate device for each patient.
Type Text
Publisher American Association of Neurological Surgeons (AANS)
Volume 101
Issue 1 Suppl
First Page 53
Last Page 58
Subject Head trauma; Ventriculostomy; External ventricular drain; Monitoring; Fiberoptic monitor
Subject LCSH Intracranial pressure; Head -- Wounds and injuries; Children -- Wounds and injuries
Language eng
Bibliographic Citation Anderson, R. C. E., Kan, P., Klimo, P., Brockmeyer, D. L., Walker, M. L., & Kestle, J. R. W. (2004). Complications of intracranial pressure monitoring in children with head trauma. Journal of Neurosurgery, 101(1 Suppl), 53-8.
Rights Management (c) American Association of Neurological Surgeons
Format Medium application/pdf
Format Extent 144,851 bytes
Identifier ir-main,13197
ARK ark:/87278/s61v5zd9
Setname ir_uspace
Date Created 2012-06-13
Date Modified 2012-06-13
ID 704946
Reference URL
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