The Roles of Ventricular and Parenchymal Intracranial Pressure Monitoring

Intracranial pressure (ICP) is highly predictive of outcome in traumatic brain injured (TBI) patients with the proportion of hourly ICP greater than 20mmHg being a significant independent determinant of outcome [1-4]. The objective of such monitoring is to maintain adequate cerebral perfusion and oxygenation so as to avoid secondary insult to the traumatically injured brain. Furthermore, prophylactic treatment of ICP without ICP monitoring carries risk such as prolonged hyperventilation which worsens outcome [5]. For this reason, the Brain Trauma Foundation Guidelines make a Level II recommendation for intracranial pressure (ICP) monitoring in all salvageable patients with a severe traumatic brain injury (TBI) that have Glasgow Coma Scale (GCS) score of 3-8 post-resuscitation and an abnormal computed tomography (CT) scan [6].