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Updated: May 13, 2026

A Detailed Protocol for Physiological Parameters Acquisition and Analysis in Neurosurgical Critical Patients
Published on: October 17, 2017
[Increased intracranial pressure and brain edema]
1Klinik für Neurologie, Klinikum Nürnberg.
Insights
Intracranial pressure (ICP) monitoring is crucial for detecting rising brain pressure during sedation. Invasive ICP monitoring remains the gold standard for assessing brain perfusion pressure (CPP).
Area of Science:
- Neurology
- Neurosurgery
- Critical Care Medicine
Abstract:
In primary and secondary brain diseases, increasing volumes of the three compartments of brain tissue, cerebrospinal fluid, or blood lead to a critical increase in intracranial pressure (ICP). A rising ICP is associated with typical clinical symptoms; however, during analgosedation it can only be detected by invasive ICP monitoring. Other neuromonitoring procedures are not as effective as ICP monitoring; they reflect the ICP changes and their complications by other metabolic and oxygenation parameters. The most relevant parameter for brain perfusion is cerebral perfusion pressure (CPP), which is calculated as the difference between the middle arterial pressure (MAP) and the ICP. A mixed body of evidence exists for the different ICP-reducing treatment measures, such as hyperventilation, hyperosmolar substances, hypothermia, glucocorticosteroids, CSF drainage, and decompressive surgery.
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