Intraventricular monitoring of the craniocerebral trauma patient

Increased intracranial pressure has been shown by many investigators to cause alterations in brain function and hemodynamics which can affect the patient's final outcome. Many methods of reducing this pressure, when it is elevated, have been devised. These vary from hyperventilation to the use of hypertonic solutions. While these are effective in many cases, it has been shown that a significant proportion of the patients will become resistant to these standard methods. The withdrawal of a few ml of ventricular cerebrospinal fluid (CSF) often dramatically reduces intracranial tension, and it is here that the ultimate value of the ventricular catheter lies. The authors demonstrate a direct correlation of prognosis and eventual diagnosis, with brain oxygen consumption, CSF hydrogen ion concentration and CSF partial pressure of oxygen. With these laboratory determinations it now appears that one can ascertain the patient's condition more accurately. They feel intraventricular monitoring has proven to be both a therapeutic and diagnostic aid in the treatment of the severely head injured patient.