Intracranial pressure (ICP) is the pressure inside the head. It may be increased in conditions which cause excess fluid to build up inside the head or may be due to a growing tumor, etc. Increased ICP can lead to brain damage or even death. Thus, it is usually monitored especially in patients with brain injury.
However, a good number of medical professionals are of the opinion that monitoring ICP does not improve the outcome/prognosis of the patient. Some even believe that monitoring ICP may complicate the treatment offered to the patient. The following are some of the disadvantages and complications associated with the use of intracranial pressure monitoring.
Invasive: ICP monitors require holes to be drilled into the skull through which the catheters used for monitoring are inserted. Some types of monitors have to be placed right inside brain tissue.
Expensive: The use of an ICP monitor includes the need for surgery for the hole to be drilled into the skull and leads to a longer stay in the hospital. It also requires the use of antibiotic medication to prevent infection and repeat CT scans. All these increase the cost of treatment. ICP monitoring equipment like the fiber-optic catheter can be very expensive.
Inaccuracy: Different types of ICP monitoring devices produce different results and when less invasive procedures are used, they usually produce less accurate measurements which could be misleading. ICP monitors need to be recalibrated frequently and some cannot be recalibrated after placement. This inability to recalibrate them means that over time, their accuracy becomes less reliable.
Intensive Care: Patients with ICP monitors require constant care. Monitors must be recalibrated frequently and obstruction by blood or tissue must be checked for. Patients must also be monitored for infection resulting from the use of the monitor. With the use of some types of ICP monitors patients must also be placed in certain positions.
Malfunction: Some types of ICP monitors need to be placed inside the head or brain matter. As such they can be blocked when the brain swells which can occur especially in head trauma. The catheters used in these monitors can also be blocked by blood clots and tissue debris. These cause them to produce inaccurate results.
Difficult: The invasive types of ICP monitors can be difficult to place and requires highly skilled medical professionals. This also makes them unsuitable for use in emergency situations.
Infection: The use of ICP monitoring can lead to potentially life-threatening intracranial infections. These infections occur because of the wound (hole) that has to be created for the insertion of the catheter.
Hemorrhage: The placement of the monitor usually requires a drill-hole in the skull. This procedure could cause severe bleeding if not properly carried out. In acute fulminant hepatic failure, fatal hemorrhage occurs with the use of ICP monitors.
Trauma: There could be further brain damage during the procedure of placing the monitor especially when carried out by inexperienced persons.