Failure to measure intracranial pressure (ICP) in the childhood encephalopathies has been likened to treating heart failure without measuring the blood pressure. Raised ICP adds considerably to the morbidity and mortality of cerebral disease, yet its routine measurement remains controversial. This paper reviews the causes, measurement and management of ICP and outlines the indications for monitoring.
KlatzoI.. Cerebral oedema and ischaemia. In: SmithW.T., CavanaghJ.B., eds. Recent advances in neuropathology.Edinburgh: Churchill Livingstone, 1982: 27–39
2.
JenkinsJ.G., GlasgowJ.F.T., HicksE.M.: How useful is intracranial pressure monitoring in patients with Reye's syndrome? Paper to 58th Annual Meeting of British Paediatric Association, York, 18 April 1986
3.
LeveneM.I., EvansD.H., FordeA., ArcherL.N.J.. Direct intracranial pressure monitoring in asphyxiated newborns: What is its value? Paper to 58th Annual Meeting of British Paediatric Association, York, 18 April 1986
4.
PhilipA.G.S., LongJ.C., DonnS.M.. Intracranial pressure. Sequential measurements in full-term and pre-term infants.Am J Dis Child1981; 135: 521–4
5.
MinnsR.A.. The monitoring of intracranial pressure in infants and children. PhD Thesis, University of Edinburgh, 1979
6.
RajuT.N., VidyasagarD., PapazafiratouC.. Intracranial pressure monitoring in the neonatal ICU.Crit Care Med1980; 8: 575–81
7.
NussbaumE., MaggiJ.C.. Intracranial pressure monitoring by subarachnoid bolt in comatose children.Clin. Pediatr. (Phila)1985; 24: 329–30
8.
DeardenN.M., McDowallD.G., GibsonR.M.. Assessment of Leeds device for monitoring intracranial pressure.J. Neurosurg.1984; 60: 123–9
TeasdaleG., JennettB.. Assessment of coma and impaired consciousness. A practical scale.Lancet1974; ii: 81–4
11.
HumphreyP.R.D.. Clinical relevance of measurements of cerebral blood flow.Br J Hosp Med1981; 26: 233–11
12.
Brain Resuscitation Clinical Trial I Study Group.Randomised clinical study of thiopental loading in comatose survivors of cardiac arrest.N Engl J Med1986; 314: 397–403
13.
SteerC.R.. Barbiturate therapy in the management of cerebral ischaemia.Dev Med Child Neurol1982; 24: 219–31
14.
GoiteinK.J., AmitY., MussaffiM.. Intracranial pressure in central nervous system infections and cerebral ischaemia of infancy.Arch Dis Child1983; 58: 184–6
15.
LeveneM.I., EvansD.H.. Medical management of raised intracranial pressure after severe birth asphyxia.Arch Dis Child1985; 60: 12–16
16.
ChandlerW.F., KindtG.W.. Monitoring and control of intracranial pressure in non-traumatic encephalopathies.Surg Neurol1976; 5: 311–4
17.
NussbaumE., GalantS.P.. Intracranial pressure monitoring as a guide to prognosis in the nearly drowned, severely comatosed child.J. Pediatr1983; 102: 215–8
18.
DeanJ.M., McCombJ.G.. Intracranial pressure monitoring in severe pediatric near-drowning.Neurosurgery1981; 9: 627–30
19.
SaulT.G., DuckerT.B.: Effect of intracranial pressure monitoring and aggressive treatment on mortality in severe head injury.J Neurosurg1982; 56: 498–503
20.
BowersS.A., MarshallL.F.. Outcome in 200 consecutive cases of severe head injury treated in San Diego County: a prospective analysis.Neurosurgery1980; 6: 237–42
RopperA.H.. In favour of intracranial pressure monitoring and aggressive therapy in neurologic practice.Arch Neurol1985; 42: 1194–6
23.
StuartG.G., MerryG.S., SmithJ.A., YellandJ.D.. Severe head injury managed without intracranial pressure monitoring.J Neurosurg1983; 59: 601–5
24.
PearnJ.. The management of near drowning.Br Med J1985; 291: 1447–52
25.
ShaywitzB.A., RothsteinP., VenesJ.L.. Monitoring and management of increased intracranial pressure in Reye's syndrome: results in 29 children.Pediatrics1980; 66: 198–204
26.
TraunerD.A., BrownF., GanzE., HuttenlocherP.R.. Treatment of elevated intracranial pressure in Reye's syndrome.Ann Neurol1978; 4: 275–8
27.
GlasgowJ.F.T.: Clinical features and prognosis of Reye's syndrome.Arch Dis Child1984; 59: 230–5
28.
GriswoldW.R., VineyJ., MendozaS.A., JamesH.E.. Intracranial pressure monitoring in severe hypertensive encephalopathy.Crit Care Med1981; 9: 573–6
