J Neuroanaesth Crit Care 2015; 02(03): 193-203
DOI: 10.4103/2348-0548.165039
Review Article
Thieme Medical and Scientific Publishers Private Ltd.

Intracranial pressure monitoring

Mary Abraham
1  Department of Anaesthesia and Pain, Fortis Hospital, Noida, Uttar Pradesh and Department of Neuroanaesthesia and Intensive Care, Medanta – The Medicity, Gurgaon, Haryana, India
,
Vasudha Singhal
1  Department of Anaesthesia and Pain, Fortis Hospital, Noida, Uttar Pradesh and Department of Neuroanaesthesia and Intensive Care, Medanta – The Medicity, Gurgaon, Haryana, India
› Author Affiliations

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Further Information

Publication History

Publication Date:
02 May 2018 (online)

Abstract

Brain specific monitoring enables detection and prevention of secondary cerebral insults, especially in the injured brain, thereby preventing permanent neurological damage. Intracranial pressure (ICP) monitoring is widely used in various neurological, neurosurgical and even medical conditions, both intraoperatively and in critical care, to improve patient outcome. It is especially useful in patients with traumatic brain injury, as a robust predictor of cerebral perfusion, and can help to guide therapy and assess long-term prognosis. Intraventricular catheters remain the gold standard for ICP monitoring, as they are the most reliable, accurate and cost-effective, and allow therapeutic cerebrospinal fluid drainage. Newer fibreoptic catheter tip and microchip transducer techniques have revolutionised ICP monitoring, with their ease of insertion in patients with narrow ventricles, and reduced risk of infection and haemorrhage. Furthermore, non-invasive methods of ICP monitoring, such as transcranial Doppler, optic nerve sheath diameter, etc., have emerged as promising techniques for screening patients with raised ICP in settings where invasive techniques are either not feasible (patients with severe coagulopathy) or not available (setups without access to a neurosurgeon). Therefore, ICP monitoring, as a part of multi-modality neuromonitoring, is a useful tool in the armamentarium of the neuro-intensivist in decreasing morbidity and mortality of critically ill neurological patients.