Limitations and Complications Connected with Monitoring of Subdural Intracranial Pressure and Insertion of Jugular Catheter

With any invasive monitoring procedure the risk of adverse events is present. The incidence of dural tears during opening of the surgical field has previously been reported in the literature. Predisposing factors for accidental dural tears occurring during supratentorial craniotomy have been reported. Predisposing factors included extracerebral pathology (meningioma), age of the patients, thickness of the cranial vault, the presence of hyperostosis frontalis and a frontal or pterional location. In elderly patients adhesions between the dura and the skull are increased, leaving dura more vulnerable during craniotomy. Moreover, with respect to the auxiliary surgical tools, the use of the drill was associated significantly with dural tears. In this chapter the adverse effects of subdural monitoring are disclosed. In addition the potential dangers of jugular venous puncture and wound infection are discussed.