Continuous Monitoring of Cortical Blood Flow and Intracranial Pressure in Severe Cerebral Trauma

Abstract

It is commonly accepted practice to monitor intracranial pressure (ICP) in patients with severe head injury. Elevation of ICP is treated with appropriate measures to normalize ICP such as hyperventilation, diuretics, mannitol, drainage of CSF, and barbiturates. The various treatment modalities affect cerebral blood flow (CBF) flow differently. Therefore, knowing the CBF may help in selecting the proper treatment modality. Jaggi et al. (1990) demonstrated that patients who do poorly may either have markedly elevated CBF (hyperemia) or very low blood flows (ischemia). It may be that these two groups need to be treated in a different fashion. A continuous monitor of CBF may allow more appropriate treatment and hopefully decrease the risk of secondary neurological deficit.