Monitoring of intracranial pressure in patients with severe head injury.

Direct measurements of intracranial pressure in 100 patients with severe cranio-cerebral injuries showed that the development and progress of the post-traumatic brain edema did not follow any definite pattern. Likewise, the clinical findings did not allow any clear conclusions to be drawn regarding the height of the intracranial pressure. Among the different osmotic and saline diuretics tested, only mannitol and sorbitol seemed to be able to produce a rapid and effective lowering of acutely raised pressure. Indeed, even here the duration of the action varied very widely. Apart from the usual routine treatment, dexamethasone in very high doses was able significantly to reduce the frequency of pathological rises of pressure. By means of high doses of steroids and monitoring of the intracranial pressure, the mortality after severe brain injuries can be significantly reduced.