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Intracranial Pressure Monitoring

The Brain is a very complex system. It consists of nerves as well as fluids. The fluid in the Brain is called Cerebrospinal fluid. This is necessary as it forms a cushion that keeps the Brain and Spinal cord from accidental injury. It also delivers vital nutrients in the body and removes waste from the Brain. This liquid gets continuously absorbed by the bloodstream. Sometimes a problem in the brain can cause this fluid to rise and dip.

Normal Intracranial pressure should be between 5 to 15 mm Hg. The process to measure the spinal fluid is known as Intracranial pressure monitoring. This is the latest technology used by Brain surgeons to monitor the brain’s pressure level. This is performed by neurologists in special circumstances. In this ICP monitoring, a small pressure-sensitive probe is inserted in the skull. This helps in understanding the Brain’s fluid level.

In Intracranial pressure monitoring, an intraventricular catheter is inserted in the Brain through a small hole. This is a tube-like structure giving the accurate reading of spinal fluid. This helps the surgeon in deciding if the pressure in Brain is high or low.

Most neurosurgeons would recommend this only in certain special conditions like Brain Trauma or Brain tumour. It gives the most accurate Intracranial pressure at the time of the procedure itself. This plays an essential role in diagnosing and monitoring brain conditions.

The Intracranial pressure may vary if a person is sleeping. In some conditions, it may also change if the brain has a tumour.

This is not a usual technique but is rather much more efficient than the traditional methods. Most surgeons would recommend this only if;

1. Someone who has an elevated TBI without any reason. In this situation, a person will not have cerebral edema or intraventricular haemorrhage.

2. A person has a lesion in the back of the skull. This test diagnosis can confirm the presence of a tumour

3. A person has sudden undergone sudden brain trauma like an accident on the head.

In all these scenarios, The ICP level would read as 20 mm Hg. It helps neurosurgeons in giving the right line of treatment. It is done, before and after every brain surgery. ICP shows fluid level as higher than after the surgery. It is to check if decompressive craniectomy has lessened after the surgery.

It is the most used technique used by brain surgeons. It is a way to know that surgery is successful.

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DR KALYAN BOMMAKANTI

NeuroSurgeon & Spine Surgeon


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