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Introduction: Intracranial pressure (ICP) monitoring is a very commonly performed neurosurgical procedure but there is a wide variation in how it is reported, hindering analysis of it. The current study sought to generate consensus on the reporting of ICP monitoring recording data.
Research Question: "What should be included in an ICP monitoring report?"
Material And Methods: The exercise was completed via a modified eDelphi survey. An expert panel discussion was held from which themes were identified and used to produce a code to annotate the transcript of the discussion. Statements were generated for a further two rounds of electronic questionnaires distributed via the REDcap platform. A Likert scale was used to grade agreement with each statement in the survey. A statement was accepted if more than 70% agreement was achieved between respondents. Data was collated using Microsoft Excel and analysed using R.
Results: 149 relevant statements were identified from the transcript and categorised into recording parameters, waveform characteristics or reporting. A total of 22 statements were generated for the first round of the survey which was answered by 39 respondents. Following the electronic round of surveys consensus was achieved for all but one statement regarding the acceptability of automating ICP reporting. This was put forward to a second round after which 79% agreement was reached.
Discussion And Conclusion: The themes and statements from this eDelphi can be used as a framework to allow the standardisation of the reporting of intracranial pressure monitoring data.
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http://dx.doi.org/10.1016/j.bas.2024.102860 | DOI Listing |
Interv Neuroradiol
September 2025
Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
IntroductionVenous sinus stenting (VSS) is an effective, less invasive alternative to ventriculoperitoneal shunting (VPS) for idiopathic intracranial hypertension (IIH). While efficacy is comparable, with some evidence favoring VSS for headache control, perioperative costs remain under-characterized due to reliance on reimbursement rates rather than actual expenditures.ObjectiveTo compare the perioperative cost of elective VSS and VPS for IIH, including outpatient workup and follow-up costs, using detailed institutional cost data.
View Article and Find Full Text PDFThis manuscript explores the myriad ethical controversies associated with declaration of brain death/death by neurologic criteria (BD/DNC) during pregnancy raised by the case of Ms. Adriana Smith, a 30-year-old Georgia nurse, who came to international attention in May 2025. We will discuss: (1) the factors that may have impacted the decision not to perform neuroimaging when she first presented to medical attention; (2) the significance of identifying and deferring performance of futile interventions to decrease intracranial pressure relative to BD/DNC declaration; (3) the medical, ethical and legal complexities associated with BD/DNC declaration and continuation of maternal organ support in pregnancy; (4) the impact of continuing maternal organ support after BD/DNC declaration on the fetus, the family, Ms.
View Article and Find Full Text PDFPediatr Crit Care Med
September 2025
Waisman Brain Imaging Laboratory, University of Wisconsin, Madison, WI.
Objectives: Elevated intracranial pressure (ICP) is a complication of severe traumatic brain injury (TBI) that carries a risk of secondary brain injury. This study investigated the association between ICP burden and brain injury patterns on MRI in children with severe TBI.
Design, Setting, And Patients: Secondary analysis of the Approaches and Decisions in Acute Pediatric TBI (ADAPT) study, which included children with severe TBI (Glasgow Coma Scale score < 9) who received a clinical MRI within 30 days of injury.
Cureus
August 2025
Emergency Medicine, All India Institute of Medical Sciences, New Delhi, New Delhi, IND.
Background Increased intracranial pressure (ICP) can be reliably detected at the bedside using the optic nerve sheath diameter (ONSD). The functional outcome in stroke patients can be predicted with the use of acute-phase ONSD dynamics. Objectives To determine the predictive accuracy of ONSD on days 0, one, and three for the prognosis of ischemic stroke patients presented to emergency medicine as measured by Modified Rankin Scale (mRS) score.
View Article and Find Full Text PDFClin Neurol Neurosurg
September 2025
Department of Neurosurgery and Spine Surgery, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; Center for Translational Neuro, & Behavioral Sciences (C-TNBS), University of Duisburg Essen, Germany.
Objective: Accurate prediction of the initial severity of aneurysmal subarachnoid hemorrhage (aSAH) is important for effective management of unruptured intracranial aneurysms (IA). This study aims to investigate patient and IA characteristics as pre-rupture predictors of severe aSAH.
Methods: This retrospective analysis included all patients aged 18 years or older diagnosed with acute aSAH at our center between January 2003 and June 2016.