Posttraumatic monitoring of intracranial pressure

ICP-monitoring is a good guide for surgical and nonsurgical treatment of unconscious patients with severe traumatic brain injuries. Intraventricular and extradural recordings usually are reliable but have systematic differences. Subdural screws tend to underestimate ICP greater than 20 mm Hg. High ICP correlates with poor outcome. Plateau-waves induced by external stimulation indicate a tight brain situation requiring treatment. In critical situations monitoring of the cerebral perfusion pressure is recommended. ICP recordings can never substitute personal supervision of the patient.