Telemetric Intracranial Pressure Monitoring: History, Types, Benefits, Indications, and Complications



Khormali M¹ ; Khayat Kashani HR² ; Sharifalhoseini M¹ Show Affiliations
Source: Horizons in Neuroscience Research. Volume 44 Published:2021

Abstract

Accurate, safe, and long-term intracranial pressure (ICP) monitoring is valuable in managing certain neurological and neurosurgical conditions. Various methods have been suggested and applied so far. External ventricular drain (EVD) and intraparenchymal monitors (IPM) as conventional invasive methods have been used for continuous ICP monitoring. EVD is probably considered the most common and accurate method of ICP monitoring, which in many cases has both therapeutic and diagnostic applications. However, its chronic use has been associated with infectious complications. Although IPM has lowered the complication rate and invasion compared with EVD, both introduce certain drawbacks for prolonged ICP monitoring: they are only applicable at the bedside in inpatient/critical care settings and restrict patient's movements. On the other hand, noninvasive techniques, such as tympanic membrane displacement, transcranial Doppler, and electroencephalography, are made by indirect measures. In turn, they are less accurate techniques to apply to patient care in the long run. In the 1960s, telemetry was proposed as a new solution for long-term ICP monitoring. Technological advances, especially in the last decade, promoted the accuracy of telemetric techniques and expanded their use. Nowadays, telemetric ICP monitoring (TICPM), as a less invasive low complication method with accuracy comparable to conventional wired techniques, can be conveniently used in hospitals, ambulatory care centers, or even home settings under daily living conditions without restricting the patient's movements. It can be cost-effective by decreasing repeated measurements, hospital length of stay, and the need for follow-up imaging. Indications for TICPM can be divided into two categories: 1. assessing patients' response to treatments of hydrocephalus, and conditions with intracranial hypertension/ hypotension, 2. confirmation of suspected CNS disorders such as intracranial hypertension/hypotension and hydrocephalus, especially in patients with complex disorders that confirmation cannot be done by episodic measurements or short-term monitoring in inpatient settings. New-onset seizure, explantation of the sensor due to skin damage, infectious complications (wound infection and brain abscess), intracranial peri-sensor hemorrhage, ethylene oxide allergy, and sensor malfunction are the most commonly reported complications of this technique. This chapter reviews the history, types, indications, benefits, and complications of telemetric ICP monitoring. © 2021 Nova Science Publishers, Inc.