Continuous Intracranial Pressure Monitoring in Patients with Brain Injury: Technique and Application

Continuous ICP monitoring using the hollow screw technique has proven itself simple, safe, and reliable. The obvious advantage of continuous ICP monitoring is to provide early warning of developing mass lesions before clinical signs appear and to assess the effectiveness of therapy directed at brain edema. Its most important use, however, may be that it permits the use of depressant medications in these patients. Many of these patients have a marked tendency toward hyperthermia, severe hyperventilation, and erratic blood pressure swings. These tendencies can be most difficult to control with conventional treatment regimens. By sedating these patients, however, it is easy to override these tendencies with a respirator, a simple heat exchange mattress, and patient positioning. In many of these patients, all of the intracranial compensatory mechanisms for the maintenance of brain metabolism have been maximally taxed