To the Editor.
—I would like to offer several comments in regard to the article by Ropper and King1 on intracranial pressure (ICP) monitoring in patients with cerebral hemorrhage. While agreeing with the overall theme of their report, ie, that ICP monitoring can provide information that is essential for optimal management, I think several important points were overlooked. First, there was no description of the size of hematomas in their patient population, and it would appear that most of the patients were comatose primarily not because of elevated ICP, but because of lesions located in the basal ganglia or thalamus. Whether ICP monitoring is of benefit for all patients with this type of lesion is questionable, and methods for identifying appropriate candidates need to be addressed.Second, the most challenging issue with ICP monitoring—what to do with the information—still remains. The unfortunate aspect of Ropper and King's article was
Duff TA. Intracranial Pressure Monitoring in Patients With Cerebral Hemorrhage. Arch Neurol. 1985;42(12):1134. doi:10.1001/archneur.1985.04060110012004
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