To improve the quality of emergency and critical care and prevent the brain from irreversible and long-term damage caused by the continuous rising of intracranial pressure in patients with severe brain injuries, intracranial pressure (ICP) monitors are covered by NHI from July 1, 2022, benefiting about 3,000 people.
Dr. Po-Chang Lee, Director General of the NHIA, said that since 1995, NHI has covered the external ventricular drain set, which can indirectly monitor intracranial pressure during the draining of cerebrospinal fluid. An ICP monitor is directly inserted into the patient's brain to provide physicians with another monitoring method. It can directly and accurately monitor changes in the patient's intracranial pressure in real time, and assists the physician in clinically judging whether the patient's brain injury requires surgery, without being hindered by the swelling of the patient's brain or collapse of the ventricle. Early detection of changes in intracranial pressure for patients with brain injuries or after surgeries can save lives and provide better prognosis, making the ICP monitor a necessary medical device for emergency and critical clinical care.
The human skull encapsulates brain tissue, blood, and cerebrospinal fluid. Under normal conditions, the internal volume of the cranial cavity can remain stable and balanced and will generate a uniformly distributed positive pressure-this is known as intracranial pressure. In the event of head trauma, intracranial hemorrhaging, cerebral edema, intracranial tumor, or abscess causing a sudden increase in intracranial pressure, blood flow to the brain will be reduced or stopped, resulting in destructive nerve damage, and damage and death of brain tissue due to ischemia. It may even cause brain tissue displacement due to the increase in pressure, compressing the brain stem and causing brain death of the patient. Therefore, it is extremely important for the prevention of brain injury that physicians detect increased intracranial pressure in patients early and give appropriate and timely treatment.
The NHIA stated that the use of the above-mentioned medical devices must be clinically evaluated by a physician to see if the case meets indications. ICP monitors are limited to use in patients for their initial CT scans indicating structural brain injuries, patients found to have elevated intracranial pressure through clinical manifestation or imaging studies, or in patients with cerebral edema exceeding the boundary of the skull with markedly elevated intracranial pressure during craniotomy. ICP monitors with drainage functions are limited to use in patients with hydrocephalus and elevated intracranial pressure.