[Intracranial pressure determination in neuro-traumatology. Indications, interpretation and complications]

Intracranial pressure (ICP) monitoring in patients with severe head injury is useful in understanding the physiopathology of cerebral contusion, proper planning of treatment and assessment of prognosis. ICP should be monitored in patients with severe head injury presenting with coma, signs of brainstem involvement and an abnormal CT-scan. ICP values must be considered in conjunction with other parameters, especially blood pressure. Normal ICP does not rule out the development of intracranial hematoma, thus emphasizing the importance of clinical examination and of control CT-scans if the patients are paralyzed and artificially ventilated. Monitoring should be discontinued as soon as possible since, the complication rate correlates with the duration of ICP monitoring.