title: Advances in Intracranial Pressure Monitoring and Its Significance in Managing Traumatic Brain Injury.
abstract: Intracranial pressure (ICP) measurements are essential in evaluation and treatment of neurological disorders such as subarachnoid and intracerebral hemorrhage, ischemic stroke, hydrocephalus, meningitis/encephalitis, and traumatic brain injury (TBI). The techniques of ICP monitoring have evolved from invasive to non-invasive-with both limitations and advantages. Some limitations of the invasive methods include short-term monitoring, risk of infection, restricted mobility of the subject, etc. The invasiveness of a method limits the frequency of ICP evaluation in neurological conditions like hydrocephalus, thus hampering the long-term care of patients with compromised ICP. Thus, there has been substantial interest in developing noninvasive techniques for assessment of ICP. Several approaches were reported, although none seem to provide a complete solution due to inaccuracy. ICP measurements are fundamental for immediate care of TBI patients in the acute stages of severe TBI injury. In severe TBI, elevated ICP is associated with mortality or poor clinical outcome. ICP monitoring in conjunction with other neurological monitoring can aid in understanding the pathophysiology of brain damage. This review article presents: (a) the significance of ICP monitoring; (b) ICP monitoring methods (invasive and non-invasive); and (c) the role of ICP monitoring in the management of brain damage, especially TBI.
authors.affiliation: Department of NeuroTrauma, Naval Medical Research Center, Silver Spring, MD 20910, USA. usmah.kawoos.ctr@mail.mil.
authors.forename: Usmah
authors.initials: U
authors.lastname: Kawoos
authors.affiliation: Department of NeuroTrauma, Naval Medical Research Center, Silver Spring, MD 20910, USA. richard.m.mccarron.civ@mail.mil.
authors.forename: Richard M
authors.initials: RM
authors.lastname: McCarron
authors.affiliation: Department of NeuroTrauma, Naval Medical Research Center, Silver Spring, MD 20910, USA. Charles.r.auker.ctr@mail.mil.
authors.forename: Charles R
authors.initials: CR
authors.lastname: Auker
authors.affiliation: Department of NeuroTrauma, Naval Medical Research Center, Silver Spring, MD 20910, USA. mikulas.chavko.ctr@mail.mil.
authors.forename: Mikulas
authors.initials: M
authors.lastname: Chavko
mesh_terms: D000818:Animals; D001921:Brain / Q000503:physiopathology*; D001930:Brain Injuries / Q000175:diagnosis* / Q000503:physiopathology*; D019937:Diagnostic Techniques and Procedures; D019468:Disease Management; D006801:Humans; D007427:Intracranial Pressure; D013686:Telemetry / Q000379:methods
keywords: intracranial pressure; invasive methods; non-invasive methods; telemetry; traumatic brain injury; waveform analysis