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ICP monitoring

Types of ICP Monitoring, ranked by accuracy, reliability and cost (Ref: Brain Trauma Foundation Guidelines)

ICP monitor

Advantages

Disadvantages

1. Intraventricular devices

(Fluid coupled catheter with external strain gauge)

Most accurate

Allows drainage of CSF as treatment or for culture

Inexpensive

Can give intrathecal antibiotics

Can re-zero in situ

 

Higher infection rate (less so with antibiotic impregnated)

Can block with air, blood and debris

Fail with ventricular collapse

 

2. Parenchymal pressure transducer devices

Can use with collapsed ventricles

Not dependent on fluid coupling

Low infection rate

Cannot recalibrate in vivo (issue after 5 days)

Cannot drain CSF

Local not global pressure measure

3. Subdural devices

No parenchymal damage

Inaccurate, unreliable

4. Subarachnoid fluid coupled devices

No parenchymal damage

Inaccurate, unreliable

5. Epidural devices

No parenchymal damage

Inaccurate, unreliable

Codman (usually Intraparenchymal) ICP monitor





External Ventricular Drain


ICP Waveform
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