Advances in Intracranial Pressure Monitoring and Its Significance in Managing Traumatic Brain Injury

Abstract

Intracranial pressure (ICP) measurements are essential in evaluation and treatment of neurological disorders such as subarachnoid and intracerebral hemorrhage, ischemic stroke, hydrocephalus, meningitis/encephalitis, and traumatic brain injury (TBI). The techniques of ICP monitoring have evolved from invasive to non-invasive—with both limitations and advantages. Some limitations of the invasive methods include short-term monitoring, risk of infection, restricted mobility of the subject, etc. The invasiveness of a method limits the frequency of ICP evaluation in neurological conditions like hydrocephalus, thus hampering the long-term care of patients with compromised ICP. Thus, there has been substantial interest in developing noninvasive techniques for assessment of ICP. Several approaches were reported, although none seem to provide a complete solution due to inaccuracy. ICP measurements are fundamental for immediate care of TBI patients in the acute stages of severe TBI injury. In severe TBI, elevated ICP is associated with mortality or poor clinical outcome. ICP monitoring in conjunction with other neurological monitoring can aid in understanding the pathophysiology of brain damage. This review article presents: (a) the significance of ICP monitoring; (b) ICP monitoring methods (invasive and non-invasive); and (c) the role of ICP monitoring in the management of brain damage, especially TBI.

Management of intracranial hypertension in patients neurocriticos: integrative review

“…In summary the possible effects adeversos stand out as isquemia cerebral, 6,13 hypoxia/hypoxemia cerebral, [14][15][16][17][18][19][20][21][22] The main secondary causes (extracranial) are airway obstruction; Hypoxia or hypercapnia or hypercarbia (hypoventilation); Hypertension (pain / cough) and hypotension (hypovolemia / sedation); Posture of the patient (head rotation); hyperpyrexia; seizures; And metabolic drugs (e.g., tetracycline, rofecoxib, divalproex sodium, lead poisoning); Others (eg, cerebral edema high altitude, liver failure). The causes of HIC postoperative can present as a mass lesion (hematoma); Edema; Increased cerebral blood volume (vasodilation); LCR disorders.…”

“…The causes of HIC postoperative can present as a mass lesion (hematoma); Edema; Increased cerebral blood volume (vasodilation); LCR disorders. 5,[13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] The most commonly used technique in clinical practice to monitor the peak involves an intraventricular or intraparenchymal catheter system, which is still considered the gold standard for monitoring ICP. These advances in PIC monitoring technique provides a variety of methods to assess ICP.…”

A Colombian-based survey on ventriculostomy and intracranial pressure monitor placement practices

“…Despite the work of Chestnut, who conducted a prospective study in which he reported that the use of ICP is no better than using image studies and clinical examination in the intensive care management of traumatic brain injury, these results cannot be extrapolated in all the cases. (9)(10)(11)(12)(13)(14)(15). The BTF recommends the use of ICP monitoring for the management of patients with neuronal trauma.…”

Desenvolvimento De Tecnologia Digital Educacional Sobre Monitoração Da Pressão Intracraniana Minimamente Invasiva

“…The idea of noninvasive monitoring of ICP is attractive, as it eliminates most of the problems associated with invasive monitoring. 1 Thus, a new ICP monitoring method has been discovered and developed in Brazil that is minimally invasive. An extensometer with a strain gauge sensor is attached to the skull and is capable of capturing the bone deformations resulting from the variation of intracranial pressure.…”