The major influence of the atmosphere on intracranial pressure: an observational study.

The impact of the atmosphere on human physiology has been studied widely within the last years. In practice, intracranial pressure is a pressure difference between intracranial compartments and the surrounding atmosphere. This means that gauge intracranial pressure uses atmospheric pressure as its zero point, and therefore, this method of pressure measurement excludes the effects of barometric pressure's fluctuation. The comparison of these two physical quantities can only take place through their absolute value relationship. The aim of this study is to investigate the direct effect of barometric pressure on the absolute intracranial pressure homeostasis. A prospective observational cross-sectional open study was conducted in Szczecin, Poland. In 28 neurosurgical patients with suspected normal-pressure hydrocephalus, intracranial intraventricular pressure was monitored in a sitting position. A total of 168 intracranial pressure and atmospheric pressure measurements were performed. Absolute atmospheric pressure was recorded directly. All values of intracranial gauge pressure were converted to absolute pressure (the sum of gauge intracranial pressure and local absolute atmospheric pressure). The average absolute mean intracranial pressure in the patients is 1006.6 hPa (95 % CI 1004.5 to 1008.8 hPa, SEM 1.1), and the mean absolute atmospheric pressure is 1007.9 hPa (95 % CI 1006.3 to 1009.6 hPa, SEM 0.8). The observed association between atmospheric and intracranial pressure is strongly significant (Spearman correlation r = 0.87, p < 0.05) and all the measurements are perfectly reliable (Bland-Altman coefficient is 4.8 %). It appears from this study that changes in absolute intracranial pressure are related to seasonal variation. Absolute intracranial pressure is shown to be impacted positively by atmospheric pressure.