Key messages

• The normal range for intracranial pressure is zero to 10 mmHg. The threshold for treatment of increased intracranial pressure is generally accepted to be 20 mmHg or greater.

• Indications for intracranial pressure monitoring include severe head injury, subarachnoid hemorrhage, comatose meningoencephalitis, hepatic encephalopathy, Reye's syndrome, and following craniotomy.

• Intracranial pressure can be monitored from the intraventricular, intraparenchymal, subarachnoid, subdural, and epidural compartments.

• Fiber-optic catheter devices have been shown to drift during prolonged monitoring. Miniature strain gauge devices have less tendency to drift. Subarachnoid or subdural fluid-coupled devices and epidural devices are less accurate.

• Complications associated with intracranial pressure monitoring include infection, hemorrhage, malfunction, and malposition.

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