​Indications

• Glasgow coma score 8 or less after resuscitation with

1. An abnormal CT head scan, or
2. A normal CT head scan but with 2 or more high risk factors

• Age >40
• Hypotension systolic bp <90mmHg
• Abnormal motor posturing
  
• Patients who require sedation and/or ventilation hence making clinical exam difficult such as in a setting of multiple system injury
• Post surgery monitoring
• This is a more sensitive and accurate method of measuring intracranial pressure (ICP) which also enables quantification of the ICP value. The reliance of clinical signs and parameters to indicate raised or rising ICP is a qualitative method which is not as sensitive or accurate. The use of an ICP monitor would also enable us to guide our therapeutic measures and confirm that our therapeutic measures are adequate. Failure to promptly detect and treat raised ICP can lead to brain injury resulting in disability and even death.

​​Complications

• Infection
• Haemorrhage
• Malfunction

Procedure Description

General anaesthesia

• After cleaning, local anaesthetic is infiltrated and a linear incision is made
• A burr hole is created by drilling the skull bone till the inner table is breached
• The dural covering is diathermised along with the underlying pia and the monitor is then inserted into the brain and tunnelled out of the scalp
• The incision is closed

• The patient is sent back to ICU for close monitoring
• The ICP values are recorded and charted
• Vital parameters will also be monitored in conjunction with ICP