Acta Neurochirurgica

, Volume 160, Issue 9, pp 1699–1700 | Cite as

Intracranial pressure (ICP) monitoring in diffuse brain injury: to do or not to do?

  • Ravi Sharma
  • Vivek TandonEmail author
  • Dattaraj Sawarkar
  • Manoj Phalak
  • Amol Raheja
  • Shashank S. Kale
Letter to the Editor - Brain trauma
Part of the following topical collections:
  1. Brain trauma

Dear Sir,

We read with great interest the article in your journal by Vora et al. regarding the role of intracranial pressure (ICP) monitoring in diffuse brain injury titled “Intracranial pressure monitoring in diffuse brain injury-why the developing world needs it more?” [4].

We commend the authors for evaluating the role of ICP monitoring in long-term outcomes of patients with diffuse brain injury. It was indeed interesting to note that they found statistically significant improvement in the extended Glasgow outcome scale (GOS-E) at 1 month in the ICP monitoring group. Moreover, a better 2 weeks and 6 months mortality rates in the ICP-monitored group were observed, though it was not statistically significant.

However, we would like to discuss a few shortcomings of the article as below:
  1. 1.

    Need for brain-specific treatment and number of CT scans required were assessed as a secondary outcome according to the authors in this study. However, in the non ICP monitoring group, the authors...



Intracranial pressure


Randomized evaluation of surgery with craniectomy for uncontrollable elevation of intracranial pressure


Decompressive craniectomy trial


Traumatic brain injury


Compliance with ethical standards

Conflict of interest

On behalf of all the contributors, the corresponding author states that there is no conflict of interest.


  1. 1.
    Cooper DJ, Rosenfeld JV, Murray L et al (2011) Decompressive craniectomy in diffuse traumatic brain injury. N Engl J Med 364(16):1493–1502CrossRefPubMedGoogle Scholar
  2. 2.
    Hutchinson PJ, Kolias AG, Timofeev IS et al (2016) Trial of decompressive craniectomy for traumatic intracranial hypertension. N Engl J Med 375(12):1119–1130CrossRefPubMedGoogle Scholar
  3. 3.
    Marshall LF, Marshall SB, Klauber MR, Van Berkum Clark M, Eisenberg H, Jane JA, Luerssen TG, Marmarou A, Foulkes MA (1992) The diagnosis of head injury requires a classification based on computed axial tomography. J Neurotrauma 9(Suppl 1):S287–S292PubMedGoogle Scholar
  4. 4.
    Vora TK, Karunakaran S, Kumar A et al (2018) Intracranial pressure monitoring in diffuse brain injury-why the developing world needs it more? Acta Neurochir 160(6):1291–1299CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  • Ravi Sharma
    • 1
  • Vivek Tandon
    • 1
    Email author
  • Dattaraj Sawarkar
    • 1
  • Manoj Phalak
    • 1
  • Amol Raheja
    • 1
  • Shashank S. Kale
    • 1
  1. 1.Department of NeurosurgeryAll India Institute of Medical SciencesNew DelhiIndia

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