Intracranial Pressure Monitoring

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Abstract
The roles of intracranial pressure (ICP) monitoring and control are both unique and vital to neurocritical care. When ICP rises above safe thresholds, serious consequences can ensue. As ICP rises, it decreases cerebral perfusion pressure (CPP) and may decrease cerebral blood flow (CBF) if not compensated by the intrinsic autoregulatory capacity of the brain. This chapter focuses on the invasive monitors of ICP. The Monroe-Kellie doctrine states that the sum of the volume of blood, cerebrospinal fluid (CSF) and brain parenchyma must remain constant within the fixed dimensions of the rigid skull. These three components are essentially noncompressible and displace each other within the cranial vault to maintain a similar volume and pressure. There are four main locations within the brain where ICP monitoring devices are frequently placed: fluid filled ventricle, brain parenchyma, subarachnoid, and epidural space.

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