Monitoring of Intracranial Pressure (ICP): A Review

Everyone interested in neuroanaesthesia talks about intracranial pressure (ICP), but in daily clinical practice nobody measures it during craniotomy. This was the thesis that started this work more than ten years ago. A method for easy monitoring of ICP during surgery, but before opening of dura, was devised and the method was introduced in our daily clinical practice. In this chapter indications for ICP measurement, critical levels of ICP and regional differences in ICP are described. Medical approaches to ICP control are considered, including body position, hyperventilation, hypothermia and administration of barbiturate. The effect of suctioning, positive end-expiratory pressure, sedatives and analgetics are discussed as well as the use of mannitol and hypertonic saline.