INTRACRANIAL PRESSURE
MONITORING
The Glasgow coma score (GCS) is the most recognized and widely used neurological assessment tool in the UK ; however, in the intensive care unit its usefulness is limited owing to the fact that patients are sedated and sometimes paralysed. Price et al. showed that most treatment for the acute head-injured patient within ITU is based on ICP measurements rather than GCS. However, Forsyth et al. (2002) could find no evidence that using ICP monitoring reduced mortality or severe disability. Yet, several methods for monitoring changes in ICP are routinely used and, despite the lack of evidence, the Brain Trauma Foundation recommend
ICP monitoring for comatose patients with GCS < 8 and
abnormal computer tomography (CT) scan (Bullock
et al., 2000). The most commonly used methods of
ICP monitoring will be discussed with some future
developments.