Intracranial pressure in central nervous system infections and cerebral ischaemia of infancy

SUMMARY Intracranial pressure was continuously monitored in 23 patients aged between 24 hours and 20 months. Fourteen had severe infections of the central nervous system (CNS) and 9 sustained prolonged cerebral ischaemia. The intiacranial pressure measured at catheter placement was not a reliable indicator of the intracranial pressure that developed during the course of the disease. The mean maximal intracranial pressure in infants with CNS infection (57 4 ± 25 8 mmHg) was significantly higher than in infants with cerebral ischaemia (34 6 + 179 6 mmHg). Mortality in CNS infections (36 %) was closely correlated with the degree of increased intracranial pressure, while mortality in cerebral ischaemia (67 %) was not. Continuous monitoring of intracranial pressure enables treatment to be started early so that intracranial pressure can be reduced and adequate cerebral perfusion pressure maintained. This may help to reduce morbidity and mortality. Continuous monitoring ofintracranial pressure (ICP) has become an integral part of the management of childhood diseases that are accompanied by increased ICP.1-3 If not continuously monitored, undiagnosed increases in ICP may cause brain damage and carry