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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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