The purpose of our study is to register the posterior fossa pressure in normal postoperative conditions and in patients with different kinds of posterior fossa pathologies. The aim of the study is to get a range of posterior fossa intracranial pressure values in physiological situations and then to get the same data in patients with posterior fossa pathologies. The ideal would be to monitor the posterior fossa ICP in normal subjects but this is something that does not seem ethically correct. That is why, instead, the posterior fossa ICP will be measured in posterior fossa post-operative time. These patients will have to be operated any way for their posterior fossa pathologies, and adding a posterior fossa ICP sensor does not seem a problem from the ethical point of view. In any case, patients will be asked to sign informed consent. The second aim of our study will be to compare the supratentorial (frontal area) ICP monitoring with the posterior fossa ICP monitoring to see if their values coincide or if there are deviations. This will help doctors to decide when posterior fossa ICP must be done and not to rely only on supratentorial (frontal) ICP monitoring.
1. A study will be done on 12 patients. The series published to date are very short.
2. Inclusion criteria: age 18 years, traumatic pathology, tumour, ischemic or hemorrhagic posterior fossa, GCS 8 or lower.
3. EXCLUSION CRITERIA coagulation disorders, fault multi-organic, multiple pathologies, head trauma open posterior fossa with output nerve tissue.
4. Inserting PIC level sensor above-tentorial (1 sensor PIC) and another level infra-tentorial (2nd sensor PIC).
5. Verification that the ICP sensor in the posterior fossa can be implanted at the same point as we implanted it in cadavers without more significant clinical repercussions than those seen with the insertion of the ICP at the supra-tentorial level. In that sense, we have to confirm the technique's safety at the selected point away from the lateral sinus and sigmoid sinus and the lateral part of the occipital shell. We must also verify that it is not incredibly annoying for patients (in any case, it will be patients in a coma and probably sedated), but it is about confirming that the movements of the patients do not cause problems in the ICP sensor of the posterior fossa and if they do will be sought (in collaboration with the manufacturer) technical amendments necessary to avoid any problems that go detecting
6. Data Collection ICP level supra and infra-tentorial. These data will be recorded continuously on a computer for later analysis.
7. Data analysis ICP supra and infra-tentorial comparing the figures obtained in the two compartments (the supra and infra-tentorial).
8. Analysis of the correlation or non-correlation between the supra-tentorial ICP and infra-tentorial ICP figures.
9. Correlating data PIC infra-tentorial with the clinical status of patients and their evolution.
10. Analysis of possible complications attributable to the inclusion of the ICP monitor posterior fossa, analyzing possible areas for improvement to minimize any possible risk. In particular, we will analyze the risk of bruising-hematoma in the cerebellar hemisphere at the insertion point.
11. Analysis of therapeutic decisions based on figures from the PIC in the posterior fossa.
12. Analysis of the results and their correlation with therapeutic attitudes adopted.
13. Preparation of recommendations.
