Korean J Neurotrauma.  2012 Oct;8(2):128-133. 10.13004/kjnt.2012.8.2.128.

Comparison of Ventricular Type and Parenchymal Type Intracranial Pressure (ICP) Monitoring for the Severe Traumatic Brain Injury Patients

• Lee CS
• Lim YC
• Kim SH
• Cho JM

• KMID: 1427726
• DOI: http://doi.org/10.13004/kjnt.2012.8.2.128

Abstract

OBJECTIVE
Intracranial pressure (ICP) is one of the critical parameter for the patients of severe traumatic brain injury (TBI) to determine the treatment modalities and predict clinical outcomes. Hence, the ICP monitoring with accuracy and safety is essential for the TBI patients. The purpose of this study is to compare its safety and clinical usefulness of intraventricular ICP monitoring method to the parenchymal type.
METHODS
We retrospectively reviewed the medical records and imaging data of 18 severe TBI patients. We used intraventricular ICP monitoring in 10 patients and parenchymal 8 patients. We compared the clinical findings of the two type ICP monitoring methods including procedure time, neurological status, outcome, complications and mortality.
RESULTS
The initial Glasgow Coma Scale of intraventricular ICP monitoring and parenchymal ICP monitoring patients were 5.8 (range: 4-7) and 6.5 (range: 3-7) respectively. The Glasgow Outcome Scale after 6 months was a little higher in intraventricular monitoring patients than parenchymal monitoring patients (2.8 vs. 2.0, p=0.25). We could not find any intraventricular catheter related complication in intraventricular ICP monitoring patients. There was no difference in mortality in both groups (p=0.56).
CONCLUSION
Our results suggest that intraventricular catheter insertion for ICP monitoring is relatively a safe procedure in the severe TBI patients. We could not demonstrate the significant benefit of intraventricular type ICP monitoring compared with parenchymal type ICP monitoring. Considering intraventricular type ICP monitoring have advantages of the accuracy and extraventricular drainage, intraventricular type ICP monitoring could be considered for severe TBI patients, regardless of hydrocephalus.

Keyword

Extraventricular drainage; Intracranial pressure; Traumatic brain injury

MeSH Terms

Brain Injuries
Catheters
Drainage
Glasgow Coma Scale
Glasgow Outcome Scale
Humans
Hydrocephalus
Intracranial Pressure
Medical Records
Retrospective Studies

Figure

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  FIGURE 1. Computed tomography scan of 55 years old male patient with bi-frontal contusional hemorrhage and subdural hematoma. The image shows diffuse brain swelling and small sized ventricle. Under navigation guidance, extraventricular drain catheter for intracranial pressure monitoring was inserted successfully, though small sized ventricle.

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