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Monitoring and interpretation of intracranial pressure
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  • Published on:
    Intracranial metabolic monitoring: why is it not being exploited?

    Dear Editor

    This review confirms that ICP monitoring provides no information about intracerebral tissue energetiics except by inference in extremis.[1]

    This informtion is vital if the management of the disorders listed in this review and many others is to be significantly improved beyond optimal care today. There is an opportunity to obtain this information in conjunction with the ICP with the same ease and...

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    Conflict of Interest:
    None declared.
  • Published on:
    ICP and cerebral oedema at high altitude.

    Dear Editor,

    In my earlier eLetter I wrote, "Increasing blood flow to the brain by increasing pCO2 may do much more metabolic harm than good. Indeed in upregulating oxidative phosphorylation and down regulating ATP-dependent enzymatic activity... keeping the intracerebral pH abnormally low could reduce the need for blood flow to abnormally low levels". Is this statement compatible with the effects of high altitud...

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    Conflict of Interest:
    None declared.
  • Published on:
    Might intracranial pressure be a passive reflection of intracranial pH?

    Dear Editor,

    Where does fluid accumulate in intracerebral oedema, extracellulary, intracellularly or both? The distinction is important for it has a direct bearing on treatment of the intracranial compartment syndrome [1].

    If the fluid accumulates intracellularly then clamping the intra- arterial pH, using the Radiometer pH-stat automatic titrator or its equivalent[2], at an abnormally low level might r...

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    Conflict of Interest:
    None declared.