To the Editor.
—In their article on ICP monitoring of patients with intracerebral hemorrhage,1 Ropper and King suggest that this monitoring is the best way to guide treatment of elevated ICP. In addition, they state that "aggressive therapy to lower the ICP" has not been shown to improve the ultimate outcome. Furthermore, they note that "mortality was more closely tied to the level of consciousness on admission than to the ICP." How, then, does one justify the placement of a monitoring device as a means of decreasing mortality? In the specific case of surgical intervention, ICP monitoring seems not to be indicated where this type of intervention is not contemplated, especially since "surgical intervention has generally not improved the frequency of survival," at least in the patients who were comatose. The authors do not address the issue of whether treatment to lower ICP may be guided just as well by abnormalities seen
Katzin R. Intracranial Pressure Monitoring in Patients With Cerebral Hemorrhage. Arch Neurol. 1985;42(12):1134. doi:10.1001/archneur.1985.04060110012005
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