Increased cerbrospinal fluid pressure during laryngoscopy and intubation for induction of anesthesia

Intracranial pressure (ICP) was recorded in 12 patients undergoing craniotomy and 2 patients for carotid arteriogram. ICP did not change in response to the injection of contrast medium but rose significantly and dramatically in response to laryngoscopy and intubation. The increase appeared related to initial ICP and thus may represent exhaustion of compensatory mechanisms in these patients. Special attention must be given to this factor during manipulation of the larynx in neurosurgical patients with raised initial ICP or space-occupying intracranial lesions.