J Neurol Res

Journal of Neurology Research, ISSN 1923-2845 print, 1923-2853 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Neurol Res and Elmer Press Inc

Journal website http://www.neurores.org

Review

Volume 4, Number 1, February 2014, pages 1-6

A Review of Non-Invasive Methods of Monitoring Intracranial Pressure

**Table 1.** A Summary on Existing Invasive ICP Monitoring Methods From Reviews
Device	Advantage	Disadvantages
Intraventricular catheter	1. Gold standard of accuracy. 2. Allows drainage and sampling of CSF. 3. Allows ICP control. 4. Inexpensive.	1. Most invasive. 2. Sometimes difficult to cannulate ventricle. 3. Catheter can be occluded by blood or tissue. 4. Needs reposting of transducer level with change in head position. 5. Potential infection.
Subarachnoid bolt/screw	1. Quickly and easily placed. 2. Does not invade brain. 3. Allows sampling of CSF. 4. May have lower infection rate.	1. Blocked by swollen brain. 2. Catheter can be occluded by tissue or blood. 3. Must be balanced and recalibrated frequently.
Subdural, epidural catheter/sensor	1. Least invasive. 2. Easily and quickly placed.	1. Increasing baseline drift over time, accuracy and reliability are questionable. 2. Does not provide CSF sampling.
Fiberoptic probe/catheter tip strain gauge	1. Can be placed in the subdural, subarachnoid, intraventricular orintraparenchymal spaces. 2. Easily transported. 3. Minimal artefact and drift. 4. High resolution of waveform. 5. No irrigation less risk of infection. 6. No need to adjust for patient position.	1. Cannot be recalibrated after it is placed, unless a ventriculostomy is used simultaneously for reference. 2. Breakage of the fiberoptic cable. 3. High cost.
Telemetry operation	1. It supports short-term measurements. 2. It is easy to implement. 3. Allows larger range of use (home and medical center).	1. Possibility of bacteria transmission. 2. High cost. 3. Infections and complications.

Table 1. A Summary on Existing Invasive ICP Monitoring Methods From Reviews

Device

Advantage

Disadvantages

Intraventricular catheter

1. Gold standard of accuracy.
2. Allows drainage and sampling of CSF.
3. Allows ICP control.
4. Inexpensive.

1. Most invasive.
2. Sometimes difficult to cannulate ventricle.
3. Catheter can be occluded by blood or tissue.
4. Needs reposting of transducer level with change in head position.
5. Potential infection.

Subarachnoid bolt/screw

1. Quickly and easily placed.
2. Does not invade brain.
3. Allows sampling of CSF.
4. May have lower infection rate.

1. Blocked by swollen brain.
2. Catheter can be occluded by tissue or blood.
3. Must be balanced and recalibrated frequently.

Subdural, epidural catheter/sensor

1. Least invasive.
2. Easily and quickly placed.

1. Increasing baseline drift over time, accuracy and reliability are questionable.
2. Does not provide CSF sampling.

Fiberoptic probe/catheter tip strain gauge

1. Can be placed in the subdural, subarachnoid, intraventricular orintraparenchymal spaces.
2. Easily transported.
3. Minimal artefact and drift.
4. High resolution of waveform.
5. No irrigation less risk of infection.
6. No need to adjust for patient position.

1. Cannot be recalibrated after it is placed, unless a ventriculostomy is used simultaneously for reference.
2. Breakage of the fiberoptic cable.
3. High cost.

Telemetry operation

1. It supports short-term measurements.
2. It is easy to implement.
3. Allows larger range of use (home and medical center).

1. Possibility of bacteria transmission.
2. High cost.
3. Infections and complications.

**Table 2.** A Summary on Existing Non-Invasive ICP Monitoring Methods From Reviews
Technique	Advantages	Disadvantages
Modeling	1. Easy to implement. 2. Eliminates problems associated with invasive methods (complications, infections and discomfort). 3. Continuous measurement achievable.	1. Accuracy issues. 2. Lack of substantial database. 3. Issues with measuring physiological parameters. 4. Clinically not applicable.
Medical imaging	1. Easy to implement. 2. Eliminates problems associated with invasive methods (complications, infections and discomfort). 3. Clinically applicable.	1. Accuracy issues. 2. Continues measurement not achievable.
Alternative methods	1. Easy to implement. 2. Eliminates problems associated with invasive methods (complications, infections and discomfort). 3. Continuous measurement achievable. 4. Clinically applicable.	1. Accuracy issues. 2. Indirect methods of measurement.

Table 2. A Summary on Existing Non-Invasive ICP Monitoring Methods From Reviews

Technique

Advantages

Disadvantages

Modeling

1. Easy to implement.
2. Eliminates problems associated with invasive methods (complications, infections and discomfort).
3. Continuous measurement achievable.

1. Accuracy issues.
2. Lack of substantial database.
3. Issues with measuring physiological parameters.
4. Clinically not applicable.

Medical imaging

1. Easy to implement.
2. Eliminates problems associated with invasive methods (complications, infections and discomfort).
3. Clinically applicable.

1. Accuracy issues.
2. Continues measurement not achievable.

Alternative methods

1. Easy to implement.
2. Eliminates problems associated with invasive methods (complications, infections and discomfort).
3. Continuous measurement achievable.
4. Clinically applicable.

1. Accuracy issues.
2. Indirect methods of measurement.