ABSTRACT
Intracranial pressure (ICP) monitoring is a well-established neuromonitoring modality in neuro-critically ill patients.Although considered controversial in improving the outcome in traumatic brain injury (TBI) patients, current evidence from large observational studies suggests improved survival rates in the subset of severe TBI patients, managed using information from continuous ICP monitoring.
The intraparenchymal pressor monitoring devices use the catheter-tip microtransducer systems using either strain-gauge method, fiberoptic technology or pneumatic technology of pressure transduction for ICP measurements. Recent literature reveals that these devices are as accurate as the “gold standard” intraventricular devices in addition to having lower infectious and hemorrhagic risks. Henceforth, the majority of neurocritical care units prefer the intraparenchymal catheters over the ventricular catheters as standard ICP monitoring devices, unless the ventricular catheters are required for therapeutic draining of cerebrospinal fluid.
The intraparenchymal catheters can be safely inserted under local anesthesia in the operating room or at the bedside, either by the neurosurgeon, the neurointensive care specialist, or the trauma surgeon, either in the intensive care unit or in the Emergency Room. In this chapter, we discuss the detailed technique of Codman MicroSensor ICP catheter insertion along with insertion-related complications and their management.
