Methods of monitoring intracranial pressure Ventricular monitoring

A catheter is inserted into the lateral ventricle via a burr hole. The catheter may be connected to a pressure transducer or may contain a fibreoptic pressure monitoring device. Fibreoptic catheters require regular calibration according to the manufacturer's instructions. Both systems should be tested for patency and damping by temporarily raising intracranial pressure (e.g. with a cough or by occluding a jugular vein). CSF may be drained through the ventricular catheter to reduce intracranial pressure.

Subdural monitoring

The dura is opened via a burr hole and a hollow bolt inserted into the skull. The bolt may be connected to a pressure transducer or admit a fibreoptic or hi-fidelity pressure monitoring device. A subdural bolt is easier to insert than ventricular monitors. The main disadvantages of subdural monitoring are a tendency to underestimate ICP and damping effects. Again calibration and patency testing should be performed regularly.

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