What is intracranial pressure monitoring?
The monitoring of intracranial pressure(ICP monitoring) is used in treating severe Traumatic Brain Injury (TBI) Patients, but it can also be used after brain surgery. This process is called intracranial pressure monitoring(ICP monitoring). All current clinical available measurement methods are invasive and use various transducer systems (most used is insertion of a catheter into the cranium).
When the brain suffers fom severe trauma it begins to swell inside the skull. If the brain swelling goes undetected and is not treated, the brain becomes deprived of oxygen-rich blood and “starves”. This lack of oxygen causes permanent brain damage. With ICP Monitoring, which tells doctors and nurses how much swelling the brain has sustained and can drain cerebrospinal fluid, which would relieve some of the pressure, this outcome can be prevented.
How Does it Work?
The specialised probe, measuring Intracranial pressure, is inserted into the brain using a small burr hole. This may happen during scheduled surgery or in the ICU. If the probe is only measuring the pressure within the skull it will be attached to the ‘intra-cranial pressure monitor’(ICP Monitor). This monitor may be a separate monitor or integrated as part of the Bedside Monitors.
If the probe is inserted into a ventricle of the brain there will also be a drainage system whereby CSF can be removed from the ventricles. CSF (cerebrospinal fluid) is a clear fluid surrounding the brain to cushion it from the hard skull.
When the pressure in the brain increases, doctors and nurses may alter your loved ones treatment depending on a number of factors. This may include the removal of small amounts of CSF, but it may also include more sedation, high concentrated Saline to reduce the brain swelling, to make more room in the skull for the brain and assist in reducing the pressure inside the skull.
How Long Will It Be Used For?
The ICP monitor or drain usually stays in place until the pressures in the brain have been stabilised and are under control. This may take a few days, but can also be longer, depending on your loved ones condition.
Are There Any Complications?
Complications that may occur infrequently are
- Intracranial infection
- Intracerebral hemorrhage(bleeding)
- Air leakage into the ventricle or subarachnoid space
- CSF leakage
- Overdrainage of CSF leading to ventricular collapse and herniation
- Loss of monitoring or drainage capabilities due to the occlusion of the catheter with brain tissue or blood
- Inappropriate therapy because of erroneous ICP readings due to dampened waveforms, electromechanical failure, or operator error(i.e. inappropriate leveling)
Of course, if you have any questions or concerns, please discuss them with the ICU nurses and doctors.
All Intensive Care interventions and procedures carry a degree of potential risk even when performed by skilled and experienced staff. Please discuss these issues with the medical and nursing staff who are caring for your loved one.
The information contained on this page is general in nature and therefore cannot reflect individual patient variation. It is meant as a back up to specific information which will be discussed with you by the Doctors and Nurses caring for your loved one. INTENSIVE CARE HOTLINE attests to the accuracy of the information contained here BUT takes no responsibility for how it may apply to an individual patient. Please refer to the full disclaimer.