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The role of ICP monitoring in meningitis

Areej Tariq1, Pedro Aguilar-Salinas2, Ricardo A Hanel2

  • 1Department of Neurology, Division of Cerebrovascular Disease and Neurocritical Care, The Ohio State University, Columbus, Ohio; and.

Neurosurgical Focus
|November 2, 2017
PubMed

Insights

Intracranial pressure (ICP) monitoring is crucial for traumatic brain injury but lacks guidelines for CNS infections like meningitis. This review explores ICP elevation in meningitis, diagnostic challenges, and outcomes of ICP monitoring.

Area of Science:

  • Neuroscience
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Intracranial pressure (ICP) monitoring is standard for traumatic brain injury.
  • Its application in central nervous system (CNS) infections, particularly meningitis, is less established.
  • Meningitis treatment faces high mortality despite advanced therapies, with intracranial hypertension being a known complication.

Purpose of the Study:

  • To review the pathophysiology of elevated ICP in meningitis.
  • To examine the diagnostic challenges associated with increased ICP in meningitis.
  • To assess clinical outcomes related to ICP monitoring in meningitis patients.

Main Methods:

  • A comprehensive literature review was conducted.
  • Searched databases for studies on ICP, meningitis, and intracranial hypertension.
  • Focused on pathophysiology, diagnostics, and clinical outcomes.

Main Results:

  • Elevated ICP is a significant factor in meningitis mortality.
  • Diagnostic difficulties exist in recognizing and managing intracranial hypertension in meningitis.
  • Limited data exists on the specific benefits and outcomes of ICP monitoring in this population.

Conclusions:

  • ICP monitoring in meningitis warrants further investigation and guideline development.
  • Understanding ICP pathophysiology is key to improving meningitis patient outcomes.
  • Standardizing ICP monitoring protocols could enhance clinical management of meningitis.
Keywords:
BBB = blood-brain barrierCBF = cerebral blood flowCFR = case fatality rateCOX = cyclooxygenaseCPP = cerebral perfusion pressureGCS = Glasgow Coma ScaleGOS = Glasgow Outcome ScaleICP = intracranial pressureIL = interleukinNO = nitric oxidePG = prostaglandinRR = relative riskSAS = subarachnoid spaceTNF = tumor necrosis factorcerebrospinal fluidcritical careintracranial pressuremeningitis

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