[Treatment of increased intracranial pressure in craniocerebral trauma]

The management of trauma patients with increased intracranial pressure is based on maintaining a normal "milieu interne", i.e. avoiding posttraumatic hypoxia and hypotension and applying specific treatment modalities, if indicated. If there are clinical signs of increased intracranial pressure or signs of cerebral edema in the CT scan, monitoring of intracranial pressure is indicated. ICP above 20 mmHg should be treated and the cerebral perfusion pressure should be maintained between 60 and 70 mmHg. Accepted treatment modalities of increased ICP are: 1) analgosedation, 2) head elevation, 3) hyperventilation, 4) osmotherapy, 5) barbiturate therapy, and 6) THAM (tris puffer).