[Experience with measurements of intracranial pressure in post-hypoxic and post-traumatic coma]

In 27 patients intracranial pressure monitoring (ICP) was carried out for 4-5 days (severe head injury 23, hypoxia after cardiac arrest 3, brain tumor 1). Patients were included who reached a score of 8 or less on the Glasgow Coma Scale and who did not need immediate surgery. The measurements were done with epidural screws (20 patients) and with indwelling ventricular catheters 7). The individually highest ICPs were recorded 3-4 days after incident. 14 patients recovered completely, 3 remained slightly and 3 severely disabled, and 7 patients died. ICP monitoring permitted precise and rational therapeutic management but was of little value prognostically. Poor Glasgow scores were linked to high mortality. The advantages and disadvantages of the two ICP monitoring techniques are discussed. ICP monitoring is recommended as a useful and safe tool for titrated management of deeply comatose patients.