Abstract
The continuous monitoring of intracranial pressure (ICP) has found its greatest application in the management of severe head injury — and also its greatest challenge. Half of those patients who die do so because of uncontrollably elevated ICP (Miller et al. 1977, 1981). Moderately elevated ICP is associated with increased morbidity. In patients who require muscle paralysis for artificial ventilation, ICP monitoring provides key information to guide optimum conditions for cerebral perfusion. The efficacy of treatment used for raised ICP can be gauged only if ICP is actually measured. Should one agent prove ineffective, a quick decision can be made to switch to more effective treatment. This, therefore, is not a plea for ICP monitoring in the management of severe head injury. That case has already been successfully made. The purpose, rather, is to focus on causes and effects of raised ICP in patients with head injury and some aspects of treatment of intracranial hypertension.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
References
Bruce DA, Langfitt TW, Miller JD, Shutz H, Vapalahti MP, Stanek A and Goldberg H (1973) Regional cerebral blood flow, intracranial pressure and brain metabolism in comatose patients. J Neuro-surg 38:131–144
Farrar JK and Roach MR (1973) The effects of raised intracranial pressure on flow through major cerebral arteries in vitro. Stroke 4:795–806
Gennarelli TA, Obrist WD, Langfitt TW and Segawa H (1979) Vascular and metabolic reactivity to changes in pCO2 in head injured patients. In: Popp AJ, Bourke RS, Nelson LR, Kimelberg HK (eds) Neural Trauma. Raven Press, New York, p 1–8
Greenberg RP, Mayer DJ and Becker DP (1976) Correlation in man of intracranial pressure and neuroelectric activity determined by multimodality evoked potentials. In: Beks JWF, Bosch DA, Brock M (eds) Intracranial Pressure III. Springer-Verlag, Berlin, p 58–62
Greenberg RP, Sakalas R, Miller JD and Becker DP (1977) Multimodality evoked potentials and CBF in patients with severe head injury. Acta Neurol Scand 56 (Suppl 64):498–499
Gudeman SK, Kishore PRS, Miller JD, Girevendulis AK, Upper MH and Becker DP (1979) The genesis and significance of delayed traumatic intracerebral hematomas. Neurosurgery 5:309–313
Gudeman SK, Miller JD and Becker DP (1979) Failure of high dose steroid therapy to influence intracranial pressure in patients with severe head injury. J Neurosurg 51:301–306
Marshall LF, Smith RW and Shapiro HM (1979) The outcome with aggressive treatment in severe head injuries. I. The significance of intracranial pressure monitoring. J Neurosurg 50:20–25
Marshall LF, Smith RW and Shapiro HM (1979) The outcome with aggressive treatment in severe head injuries. II. Acute and chronic barbiturate administration in the management of head injury. J Neurosurg 50:26–30
Miller JD (1973) The effects of hyperbaric oxygen at 2 and 3 atmospheres absolute and intravenous mannitol on experimentally increased intracranial pressure. European Neurology 10:1–11
Miller JD (1979) Barbiturates and raised intracranial pressure. Ann Neurol 6:189–193
Miller JD, Becker DP, Ward JD, Sullivan HG, Adams WE and Rosner MJ (1977) Significance of intracranial hypertension in severe head injury. J Neurosurg 47:503–516
Miller JD, Butterworth JF, Gudeman SK, Faulkner JE, Choi SC, Selhorst JB, Harbison JW, Lutz H, Young HF and Becker DP (1981) Further experience in the management of severe head injury. J Neurosurg 54:289–299
Miller JD, Gudeman SK, Kishore PRS and Becker DP (1980) Computed tomography, brain edema and ICP in severe head injury. In: Cervos-Navarro J, Ferzt R (eds) Brain Edema. Raven Press, New York, p 413–422
Miller JD and Pickard JD (1974) Intracranial volume/pressure studies in patients with head injury. Injury 5:265–269
Miller JD, Stanek A and Langfitt TW (1972) Concepts of cerebral perfusion pressure and vascular compression during intracranial hypertension. In: Meyer JS, Schade JP (eds) Progress in Brain Research, Vol. 35, Cerebral Blood Flow. Elsevier, Amsterdam, 411–432
Pitts LH and Kaktis JV (1980) Effect of megadose steroids on ICP in traumatic coma. In: Shulman K, Marmarou A, Miller JD, Becker DP, Hochwald GM, Brock M (eds) Intracranial Pressure IV. Springer-Verlag, Berlin, p 638–642
Raichle ME, Posner JB and Plum F (1970) Cerebral blood flow during and after hyperventilation. Arch Neurol 23:394–403
Roberson FC, Kishore PRS, Miller JD, Lipper MH and Becker DP (1979) The value of serial computerised tomography in the management of severe head injury. Surg Neurol 12:161–167
Sullivan HG, Miller JD, Griffith RL and Becker DP (1978) CSF pressure-volume dynamics in neurosurgical patients. Surg Neurol 9:47–54
Sweet RC, Miller JD, Lipper M, Kishore PRS and Becker DP (1978) Significance of bilateral abnormalities on the CT scan in patients with severe head injury. Neurosurgery 3:16–21
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1983 Springer-Verlag Berlin · Heidelberg
About this paper
Cite this paper
Miller, J.D. (1983). Significance and Management of Intracranial Hypertension in Head Injury. In: Ishii, S., Nagai, H., Brock, M. (eds) Intracranial Pressure V. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-69204-8_4
Download citation
DOI: https://doi.org/10.1007/978-3-642-69204-8_4
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-69206-2
Online ISBN: 978-3-642-69204-8
eBook Packages: Springer Book Archive