A 55-year-old man on ICU has a traumatic brain injury with bifrontal contusions. He has an ICP bolt in situ. On day 3, his ICP rises to 30 mmHg. The w...

Question

A 55-year-old man on ICU has a traumatic brain injury with bifrontal contusions. He has an ICP bolt in situ. On day 3, his ICP rises to 30 mmHg. The waveform shows that the P2 component exceeds the P1 component in amplitude. What does this waveform morphology indicate?

Accepted Answer

The P2 (tidal wave) exceeding P1 (percussion wave) indicates reduced intracranial compliance - the brain's ability to accommodate volume changes is exhausted, and small further volume increases will cause disproportionately large ICP rises; this is a warning sign of imminent decompensation

Answer

Normal ICP waveform

Answer

The ICP monitor is malfunctioning

Answer

The patient is over-sedated

Answer

The waveform has no clinical significance

uk-fficm MCQ (SBA): ICP Waveform - Compliance

A 55-year-old man on ICU has a traumatic brain injury with bifrontal contusions. He has an ICP bolt in situ. On day 3, his ICP rises to 30 mmHg. The waveform shows that the P2 component exceeds the P1 component in amplitude. What does this waveform morphology indicate?