Intracranial Pressure Monitoring - What is it?
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- Опубликовано: 2 авг 2024
- Intracranial pressure monitoring is a common procedure in neurosurgery. We most often need to perform intracranial pressure monitoring in brain trauma or when we are investigating the need to divert brain and spine fluid. This is an invasive procedure that involves putting a small pressure monitoring probe inside the brain and seeing how the pressure changes over time.
In this video we will show you the equipment we use for intracranial pressure monitoring and show some of the procedure on a model.
Many thanks to Susie from Delta Surgical for providing us the model and a Raumedic bolt.
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00:00 - Introduction
01:12 - How an ICP bolt inserted?
02:40 - How long will it stay in for?
03:07 - How is it removed?
03:34 - Are ICP bolts an infection risk?
03:44 - Are there any other complications?
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This video is a collaboration with the NIHR Global Health Research Group on Neurotrauma (neurotrauma.world/). Their overarching mission is to improve global neurotrauma care through a series of projects and activities focussing on various aspects of traumatic brain injury (TBI) care in low and middle income countries (LMICs).
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✍ Script by Duranka Perera (www.durankaperera.com/)
✍ Thumb by "Broken" Bran - / brangsmith
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Have you or somebody you know had Intracranial pressure monitoring? Let us know in the comments below! 👇🏼
Yes! Last year I had an 11cm arachnoid cyst fenestrated, then a VP shunt placed
Happened to me about a month ago while I was in a coma from a brain bleed
Effective treatments to reduce pressure include draining the fluid through a shunt via a small hole in the skull or through the spinal cord. The medications mannitol and hypertonic saline can also lower pressure. They work by removing fluids from your body.
This is brilliant, thank you. Particularly useful to know it’s used in MTCs from a UK perspective 👍🏻
I remember having tubes coming from my head draining excess CSF (cerebrospinal fluid after having a pineal ependymoma successfully resected, before having 3 shunts also successfully implanted to manage my chronic hydrocephalus. This is accurate info. Liked.
Fascinating stuff! So fascinating I keep coming back lol. These videos always make me shaky just thinking about this sort of thing (most surgery hasn't bothered me since I was a kid, but brain (and eye) stuff still freaks me out for some reason). I've been watching this channel on and off for a year or so, so apparently I've come to see this feeling as a thrill 😂. Now I at least know that if I (or a loved one) ever need a neurosurgical operation, I'll understand it well enough to put my anxiety to rest and trust in the experts.
I might be getting a large arachnoid cyst removed soon, I’ve been watching a bunch of your videos to make me less stressed about any kind of potential neurosurgery.
I’m pretty sure my skull won’t be drilled in to, which is comforting
I hope
I have had this done twice. Once right after getting an EVD placed because I went into a coma from high-pressure and once to find out if my shunt was malfunctioning.
Absolutely fantastic as always 😊 thank you, 🤗
I had an ICP bolt this summer and later I had a telemetric sensor reservoir fitted when my shunt was revised. It was the best thing my surgoen could've done I wish it was cheaper and more accessible for more hydrocephalus/ IIH patients it's a game changer. I'm hoping to go into Neurosurgery myself now as it's so fascinating
Could you share what your symptoms were prior to surgery and life. I am suffering and still on the road towards finding the right answers.
I’m having one fitted on Tuesday because of shunt malfunction and it’s been really helpful thank you ✌🏻
Very clear information, thanks
This is so interesting thankyou for making it I always wanted to know how it’s done.
I had one put in after my 3rd brain tumour was removed, They wanted to make sure I was 100% stable as I had a lot of compilations like my scar leaking and stuff like that.
This was over 10 years ago so it might be a bit different now, mine was in a antenna sticking out of my head, it was a huge thing sticking up like a radio tower and every time I accidentally tapped it on the bars on the bed there was a huge spike in the graph it was really funny it kept me and my mum entertained for a few hours. Later on in the evening I got hiccups, I’m not sure why but I get really violent hiccups probably from medication. The hiccups made a even bigger spike, we found it hilarious and we couldn’t stop laughing but the laughing made the hiccups worse it turned into whole cycle.
That’s my best memory from hospital it still makes me chuckle a bit. But then came pulling it out and that’s probably the worse most traumatic memory I have.
Congratz on 100k, you deserve it.
Thank you! Have a giveaway we are going to announce on IG soon!
hi yes i have monitored neurosurgical patients almost ,always following surgery , trauma , medical incidents, as a neurosurgical nurse , it’s actually explaining other young nurses , i am afraid here in the uk we do not ever having a student , working on our unit , sometimes we may have university nursing students just observing , but its rare as we are all busy , we dont have time to explain reasons, sadly i wishwe were able to explain one how and why we need to take care of our patients along with relatives too , as well as our students who get overwhelmed with how critically ill our patients are plus how they will be frightened by the proceedures , also the nursing care we need to do , like changing lines , and taking care of all the monitoring equipment , its hard to explain , why , how , reason , prescription charts , drugs , all other monitoring, then actual nursing care , its very difficult for us to explain in their ability to actually understand , .
however its fun to have them interesting enough to have the ability and understanding that following completion of training they would be able to join us , when adequate training will commence, Then in house training ,. i
Great explication thank you 😊 💚
Amazing contents and wonderful channel.. love from India..💐
Thank you Chetan
I have I had two brain surgery’s in 2020 I have hydrocephalus and also have a shunt as well I had a colloid cyst that that staring leaking then they removed it and thought I was fine until my brain start building up with fluid again so then they put the shunt in ans I also have a aneurysm it hasn’t ruptured yet so they just keep a eye on it for now!
Good
Can you please do a video on hormones and mood (in context of brain anatomy)
I'd be interested in a vlog on IIH, I have been diagnosed for few years now and I an under nuero in North West. Seems to be inconsistencies with how us IIH people are delt with regarding shunts. For a brief example I have known Walton Centre to fit a shunt in someone with no symptoms, minor paps in eyes and opening pressure of 23! Where as I have perm eye damage, paps which keep returning every time my pressure goes up as acetazolamide doesn't seem to work anymore but my nuero won't recomend a shunt and my OP is always high? But with every year that passes I have eye damage. What are your thoughts on LPs constantly done for therapeutic reasons with IIH? Do you agree with some of the research papers which have come out of Birmingham recently on how IIH patients should be treated. Anyway would appreciate sometime your thoughts on it maybe. Your vlogs are excellent 👌
A big thank you for this one!!!
From India 🇮🇳
Do they ever use this in pediatric cases for obstructive Hydrocephalus like you would find with Spina Bifida?
While marking Kocher’s point for an EVD shunt placement, do you ensure that the point is on the midpupillary line?
Yes! We have an instructional video coming soon
Do you not repair the punctured dura before closing? Or does the bolt not go as far as to damage the dura? After suffering a cerebrospinal fluid leak im now hyper aware about these seemingly harmless procedures that require damage to the dura as chronic leaking is a debilitating condition to live with. Any lumber punctures or epidural medications need to be seriously considered and patients able to give proper informed consent as to the potential risks involved. I can understand doing it in unconscious patients, but surely the conscious ones can give you pretty valuable information based on symptoms alone as to their intercranial pressures without resorting to a bolt.
When the bolt is removed, is pain relief used? I had this done after a ventriculostomy.
I had incredibly high ICP during a stay in hospital which prompted the Surgeon to pursue a fenestration of my 9x9x5cm arachnoid cyst on the left side of my brain!
Did it work?
@@Brainbook absolutely it did, massive reduction in my symptoms, for how long it will last is anyone's guess, I didn't want to start with a shunt and the Neurosurgeons at UCLH agreed to a fenestration
@@bobbobertson69 JESUS! I thought mine was massive! My surgeon wants to monitor my ICP but he's still insisting I have a mega cisterna magna despite being symptomatic for an arachnoid cyst
Fenestration is the gold standard in my opinion
@@bobbobertson69 I know this comment is from a year ago but I am having at ICP done at UCLH soon and really nervous as I have two arachnoid cysts. What was your experience like there, is it painful etc ?
@@miaeve1667 I wouldn't say it's painful, the process is don with local anesthetic, it's uncomfortable at first having a wire in your head and carrying the logging machine with you but it's quite routine and nothing to worry about.
The team at UCLH will look after you well
I am just wondering- so when people have ICP monitoring- what are you actually looking at? depending on the patient's position and different pressure numbers - what is this indicating?
How long does it take to get your eyesight back and hearing
I do feel pressure in my head, like from the sides of my head.
I wonder if this is what I need to consider. no neurologists have found what causes my 24/7 head pressure I have had for over 20 years. Though I have adapted to getting through the days, my nights are unbearable as I cannot sleep for a great part of the night.
Did you consider it??
Can you address the insertion of electrodes for treatment of severe mental illness? There used to be a lot of talk about inter-cranial stimulation for the reduction of severe depression and psychosis. Now, we don't seem to hear much about any progress being made.
I take whey protein concentrate and a methylated multivitamin. The whey protein concentrate contains amino acids which are fuel to make neurochemicals and the multivitamin plus iodine and selenium kicks the process off
20mm of the sensor length inserted, where exactly is it? Where does ICP being monitered? Seems like there are different places? Not clear in the video?
I had that yet didn't do anything
Thank you too much for this informative video. I am a 5th grade medical student and due to covid, we don''t have any opportunity to observe the clinic. Owing to you I can still learn about Neurosurgery which is the specialty that I want to choose. Also may I kindly specify that man-made is a sexiest word which you used in your video. Many thank again :)
Lucas Moura?
I'm currently having a migraine while watching lol
Are you asleep when the bolt it removed too? I have to have this done soon and I’m pretty scared, I’m only 15 😅
@Aaliyah me too I’m only 18 also and really nervous about being awake when they take it out!
@@miaeve1667 update! I had the procedure done and they removed it yesterday and I couldn’t feel a thing! Although I didn’t have stitches so I can’t tell you how that feels but I hope things go well for you
@@celestia9893 hi again I’m due to have this finally on Saturday! When they actually do the procedure can you feel/know anything that’s going on? I’m a bit freaked out about the idea of hearing them do it