A new method and software for quantitative analysis of continuous intracranial pressure recordings

Objective. A computer software utilising a new method for quantitative analysis of intracranial pressure (ICP), was developed to provide a more accurate analysis of continuously recorded ICP. Intracranial pressure curves were analysed by the software to explore the relationship between mean ICP and the presence of ICP elevations. Methods. The Sensometrics(TM) Pressure Analyser (version 1.2) software provides a quantitative analysis of the ICP curve, presenting the ICP recordings as a matrix of numbers of ICP elevations of different levels (e.g. 20 or 30 or 40 mmHg) and durations (e.g. 0.5, 5 or 10 minutes). The number of ICP elevations may be standardised by calculating the number of elevations during for instance a 10 hour period. The computer software was used to retrospectively analyse the ICP curves in our first consecutive 127 patients undergoing continuous 24 hours ICP monitoring during the two-year period from February 1997 to December 1998. The indications for ICP monitoring were suspected hydrocephalus, craniosynostosis or shunt failure. Results. Analysis of the ICP curves revealed a rather weak relationship between mean ICP and the number of apparently abnormal ICP elevations (that is elevations of 20 mmHg or above). Abnormal ICP elevations were present in a relatively high proportion of cases with a normal mean ICP below 10 mmHg, or a borderline mean ICP between 10 and 15 mmHg. In addition, the ICP data of two cases are presented suggesting that mean ICP may be an inaccurate measure of ICP. Conclusions. The results of analysing ICP curves by means of this method and software reveal that calculation of ICP elevations of different levels and durations may represent a more accurate description of the ICP curve than calculation of mean ICP. The method may enhance the clinical application of ICP monitoring.