Intracranial Pressure Monitoring

What is intracranial pressure monitoring?

Intracranial pressure (ICP) monitoring is a crucial diagnostic evaluation that involves the insertion of a device into the head to calculate the level of pressure in the brain and surrounding structures. This procedure plays a vital role in identifying and managing serious neurological conditions.

High intracranial pressure occurs when pressure increases inside the cranial vault. This pressure results from an imbalance of brain blood or cerebrospinal fluid (a protective fluid that surrounds the brain and spinal cord) within the rigid cranial space.

The procedure aims to measure the level of intracranial pressure due to a serious traumatic head injury or nervous system disorder. It may also be performed directly after surgery to remove a tumour or repair damage to the blood vessel.

How do you perform intracranial pressure monitoring?

There are three main ways of assessing and monitoring high intracranial pressure such as:

• Intraventricular catheter: This procedure involves the insertion of an intraventricular catheter through a hole made in the skull. The catheter is then gently guided through the brain within the lateral ventricle.
• Subdural screw/bolt: A screw is placed through a hole in the skull. It is carefully inserted through the membrane (dura mater) that safeguards the brain and spinal cord. Therefore, the sensor is able to record safely within the subdural space.
• The most common method currently used is an intraparenchymal catheter, it uses a tiny hairlike catheter that is placed within the brain substance and has very good accuracy.

If the results (readings) from the procedure are abnormal, indicating high intracranial pressure, this means that the blood vessels and nervous system are under immense pressure. This can lead to serious complications such as brain herniation, which is a potentially life-threatening condition where parts of the brain are squeezed across structures within the skull. If not properly treated, high intracranial pressure can cause irreversible brain damage.

The brain is a crucial organ, so if something unusual occurs, such as brain damage, it’s crucial to seek medical assistance immediately. The longer you wait and delay the procedure, the more concerning and detrimental the condition can become.