Intra-cranial pressure changes between supine and upright
Research type
Research Study
Full title
Intra-cranial pressure changes between supine and upright postures in shunted and non-shunted patients with cerebrospinal fluid flow disorders undergoing overnight intra-cranial pressure monitoring
IRAS ID
172852
Contact name
Stuart Marsden
Contact email
Sponsor organisation
South Tees Hospitals NHS Foundation Trust
Duration of Study in the UK
1 years, 5 months, 1 days
Research summary
Fluid is produced within the brain that serves many functions, including cushioning the brain, and aiding in removing waste materials from the tissue. This fluid is normally drained away naturally, but some people produce too much or can't drain it away quickly enough. This leads to high pressures as the fluid builds up, and high pressures can result in headaches, blurred vision and nausea.
The standard way to treat this is to implant a tube (known as a shunt) to drain the fluid away into the gut or a blood vessel, where it is harmlessly absorbed into the bloodstream, and pressures in the skull are kept low. These shunts are safe and remain implanted for years without complications. To aid the doctor to decide whether a patient needs an operation to implant, remove or change a shunt, we monitor the pressures in the skull overnight at the James Cook University Hospital (JCUH). This requires a very small device to be placed through a small hole in the skull, and onto the surface of the brain. The patient remains in bed whilst specialist equipment records the pressures measured by this small device in the skull.
Pressures in the skull are higher when patients are lying down than when sitting or standing, and there is strong evidence that this difference between pressures when lying and sitting is higher in patients with a working shunt, and lower in patients without a shunt. We would ask patients to move between lying and sitting whilst the pressure in their skull is being measured. This might provide a very simple means of identifying whether a shunt is working correctly. It could also help the doctor to decide whether a patient who doesn't have a shunt could benefit from having one implanted.
REC name
North East - York Research Ethics Committee
REC reference
15/NE/0220
Date of REC Opinion
6 Aug 2015
REC opinion
Further Information Favourable Opinion