Since its introduction into clinical neurosurgical practice 25 years ago,1 continuous monitoring of intracranial pressure (ICP) has remained an area of controversy. Its proponents claim that the technique is an integral part of neurologic intensive care and should play a part in the management of every comatose patient, while opponents hold that there is no evidence that implementation of ICP monitoring influences outcome to an extent that justifies the risks of this invasive procedure.
The method of ICP monitoring described by Lundberg1 involved catheterization of the frontal horn of the lateral ventricle with fluid connection to an externally placed transducer. This provided an accurate measure of intraventricular pressure, the zero point and calibration could be checked, and the technique remains the standard against which all other methods must be judged. The problems with the technique are that the brain must be punctured, opening the possibilities
Miller JD. Intracranial Pressure Monitoring. Arch Neurol. 1985;42(12):1191–1193. doi:10.1001/archneur.1985.04060110073018
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