Intraventricular Catheters (IVCs):
These are considered the gold standard for ICP monitoring. An IVC is placed directly into the lateral ventricle, providing accurate and reliable pressure readings. It also allows for therapeutic CSF drainage to reduce ICP. However, this technique carries the highest risk of infection and hemorrhage due to its invasiveness and proximity to brain structures.
Subdural and Epidural Monitors:
These monitors are placed either beneath the dura mater (subdural) or above it (epidural). While less invasive than IVCs, they are less accurate and do not permit CSF drainage. These systems are mainly used when ventricular access is difficult or contraindicated.
Parenchymal Probes:
These fiber-optic devices are inserted directly into the brain parenchyma, providing continuous ICP readings. They are less invasive than IVCs and have a lower risk of infection, but they lack the ability to drain CSF and are more prone to calibration drift over time.
Lumbar Drains:
These are used less frequently for ICP monitoring but may be employed in cases of communicating hydrocephalus. A catheter is placed in the lumbar subarachnoid space to monitor pressure and drain CSF. However, lumbar drains can cause downward herniation in the presence of high ICP and should be used with caution.