Intracranial Pressure Monitoring Device
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Sunday, October 7, 2012
Constant monitoring of intracranial pressure is an important component of management of ICP. This is because, with frequent monitoring, health care personnel are able to identify pressure in the early course before cerebral damage occurs. Patients undergoing ICP monitoring need to be hospitalized. The procedure can be done under general anesthesia or local anesthesia.
ICP monitoring is usually done after a head injury, brain hemorrhage or if an individual is suffering from a brain or nervous system disease. It can also be performed after a brain surgery if the doctor is suspecting of a brain swelling.
Intracranial Pressure (ICP) is monitored by use of any of the following devices or procedures;
- Intraventricular Catheter (ventriculostomy)
- Subarachnoid Bolt or Screw
- Epidural or Subdural Catheter
- Fiberoptic Transducer which is placed in either the ventricular or the subdural space.
Intraventricular Catheter (Ventriculostomy)
This is an invasive procedure which involves making a small incision preferably in the dominant hemisphere of the brain and inserting a fine bore catheter into the lateral ventricle. The inserted catheter is connected to a transducer by a fluid filled system which records the ICP in electrical impulse. It is also used in draining the CSF and blood from the ventricle; an effective method used in decreasing intracranial hypertension.
The intraventricular catheter can also be used in administration of medication and instillation of air or contrast dye for patients undergoing vetriculography (imaging of ventricles). Ventriculostomy is considered to be the most accurate method of monitoring ICP.
Complications
Some of the complications associated with the use of intraventricular catheter includes; meningitis, infection, obstruction or blockage of catheter by blood or brain tissue and ventricular collapse.
Subarachnoid Screw or Bolt
A hollow device is inserted in dura matter and into subarachnoid through the skull. The screw is attached to a transducer and the recordings of the waves is done by the use of an oscilloscope (an instrument that is used to analyze and display electronic signals). The procedure is mostly used for patients that require urgent ICP monitoring.
Complications
Complications associated with the subarachnoid screw includes; infection and occlusion of the bolt by the brain tissue or blood.
An Epidural Monitor
This procedure uses a pneumatic flow sensor which is inserted between the dural tissues and the skull. The sensor are placed through a burr hole drilled into the skull. This procedure is considered less invasive, has low incidence of getting infection or complications and the pressure readings appear to me more accurate. One disadvantage of using this method is that, the excessive CSF cannot by drained.
Fiberoptic Monitoring
The catheter can be inserted into the subarachnoid space, ventricle or subdural space or into brain parenchyma. A transducer tipped catheter is used to reflect the pressure changes which is then amplified and displayed in a digital monitor. Fiberoptic is an alternative method of monitoring ICP to the three standards procedure that I have discussed in this post.
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