There are many parameters that can be used to monitor the status of a head injured patient. Of those that are most commonly used the most important appear to be intracranial pressure (ICP) and cerebral perfusion pressure (CPP). Since the landmark paper of Lundberg (1960) which first demonstrated the clinical use of ICP monitoring it has grown to become a standard technique in the management of severely head injured patients. The primary brain injury, regardless of its cause, is normally irreversible. Therefore the major factor in producing any improvements in outcome must be targeted at preventing secondary damage. There are only a few variables which can be easily treated and, due to the importance of intracranial hypertension and the significance that it has on outcome, both intracranial pressure and cerebral perfusion pressure have gained importance in patient management.
Chambers IR, Mendelow AD. Monitoring the head injured patient. Quality management in head injuries care. Euroacademia Multidisciplinaria Neurotraumatologica 2000, 33-40.
Dr. Iain R. Chambers, Cleveland Unit, Middlesbrough. Tel: +44 (0)1642-854-778.
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