Management of raised intracranial pressure after severe head injury.

The mainstay of early management following severe head injury (less than 8 on the Glasgow coma scale [GCS]) remains urgent cardiopulmonary resuscitation, triage, transfer to a neurosurgical centre, emergency CT scanning and appropriate surgical intervention (Rose et al, 1977; Seelig et al, 1981; Langfitt and Gennarelli, 1982; Bricolo and Pasut, 1984). Subsequent therapy usually includes a period of intensive care with or without artificial ventilation (Becker et al, 1977; Bruce et al, 1978; Marshall et al, 1979). Intracranial pressure (ICP) monitoring is employed in many centres during the first post-traumatic week, however conservative or aggressive the management regimen is.