Intracranial pressure monitoring

Intracranial pressure (ICP) is the most commonly monitored intracranial variable and, over the last decade, has become a key component of monitoring the injured brain during neurocritical care. ICP monitoring allows quantification of ICP, calculation of cerebral perfusion pressure, and identification of abnormal ICP waveforms. A rise in ICP is a delayed phenomenon that occurs only when intracranial compensatory mechanisms have become exhausted, and analysis of continuous ICP signals offers the possibility of identifying impending intracranial hypertension. This chapter provides the historical context of how ICP entered routine clinical practice, an overview of the physiological determinants of intracranial pressure, and a description of the systems available to measure it, including their relative advantages and disadvantages.