Intracranial Pressure After Decompressive Craniectomy

Study Overview
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Brief Summary
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Observational study to investigate the natural course of intracranial pressure (ICP) after decompressive craniectomy (DC) using long-term telemetric ICP monitoring. Patients will have continuous ICP measurement performed during the admission to the neuro-intensive care unit (NICU) and after discharge weekly measurements sessions will be performed before and after cranioplasty.

Detailed Description
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Several studies have investigated and documented the effect of DC in lowering ICP in intracranial hypertension following acute brain injuries, e.g. severe traumatic brain injury. But the natural course of ICP in these patients after the acute phase in the NICU has never been investigated. Clinical experience suggests that a DC affects cerebrospinal fluid circulation and ICP, e.g. causing hydrocephalus or subdural hygromas. The aim of this observational study is to document the natural course of ICP following DC and to investigate the effect of cranioplasty on ICP. This is done by implantation of a telemetric ICP sensor and weekly follow-up monitoring sessions after discharge from the NICU until 1 month after cranioplasty. The monitoring sessions will include standardized body positions to investigate postural ICP changes before and after cranioplasty. The project will also provide experience with telemetric ICP monitoring during the acute phase in a NICU setting.

Official Title
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Intracranial Pressure After Decompressive Craniectomy

Conditions
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Traumatic Brain Injury, Middle Cerebral Artery Stroke, Intracranial Hemorrhages, Intracranial Hypertension

Intervention / Treatment
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* Diagnostic Test: Intracranial pressure monitoring


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: age > 18 years scheduled for a decompressive hemicraniectomy for elevated ICP or signs of intracranial herniation Exclusion Criteria: skin damage in the frontal area where the telemetric ICP sensor is implanted lack of informed consent from next-of-kin or the patient's general practitioner

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Diagnostic Test: Intracranial pressure monitoring|Weekly ICP monitoring sessions beginning at discharge from the neuro-intensive care unit and carried out until 1 month after cranioplasty.|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Intracranial pressure variations | ICP is measured in standardized body positions to investigate postural changes after decompressive craniectomy and following cranioplasty | Weekly monitoring sessions from discharge from the neuro-intensive care unit to 1 month after cranioplasty | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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decompressive craniectomy, intracranial pressure, icp, telemetry, telemetric