ICP monitoring

What is intracranial pressure (ICP) monitoring?
Intracranial pressure (ICP) monitoring measures the pressure inside a patient's head, using a pressure monitor inserted through the skull. There are various reasons why this procedure may be needed, for instance, after a head injury or surgery to the brain. ICP monitoring tends to be carried out in the intensive care unit although it may be inserted in the operating theatre.The nurses and doctors will explain why ICP monitoring is needed and for how long it may be needed. It may be needed for several days.

What does ICP monitoring involve?
The ICP monitoring device (ICP bolt) is inserted in a short procedure with an anaesthetic. Once it has been innserted, the nurses will observe the patient closely. Once the ICP bolt is connected to a computer, regular readings will be taken to measure the pressure.

You may notice a change in the pressure reading if the patient does anything that alters the pressure inside his or her head e.g. moving, changing position in bed, coughing or sneezing, vomiting etc..
You will also notice that the pressure reading changes depending on whether the patient is awake or asleep. The nurse will check and record the patient's level of alertness regularly while ICP monitoring is being used. 

Are there any risks from the procedure?
ICP monitoring is considered to be a safe procedure that gives good information to understand a patient's condition and plan any treatment. However, as with all procedures, there are a few potential problems such as bleeding and infection. The nurses will check the site where the ICP bolt is inserted regularly. There is also a small chance that a small amount of cerebrospinal fluid could leak from the  insertion site.

What happens afterwards?
When ICP monitoring is no longer necessary, the ICP bolt will be removed. There is a stitch around the ICP bolt, which will be pulled tight to close the wound, helping it heal better.