Classification
Protein flow into extravascular space
Vasogenic
IC Device Non traumatic ICH
GCS ≤4 Midline Shift on CT
CPP
MAP- ICP
Outflow of CSF from intraventricular space to interstitial space
Interstitial
IC Devices-Severe TBI with normal CT
Age >40
Unilateral or bilateral posturing
SBP<90 mmHg
Three concepts of management
Monroe-Kellie Doctrine
Cerebral Perfusion Pressure (CPP)
Autoregulation
Intracellular edema
Cytotoxic or celliular
Three Causes
TBI
Tumor
Infection
Hypoxia
Hepatic Failure
Ischemic Strokes
Non-traumatic ICH
Three compartments for ICP management
CSF
Blood
Brain tissue
Affecting osmolarity
Osmotic
Contraindications for ICP monitoring
Concurrent use of anticoagulant drugs
Bleeding disorder
Scalp infections
Brain abscess
Complications of Ventricular Catheter
vIntracranial and tract hemorrhage - 10%
Infection (ventriculitis) - 20%
Technical failure - 5%
Over-drainage can lead to aneurysmal rebleed
Kinks and blockages by air, blood, and debris
Localized elevations of ICP