Intracranial Pressure Monitoring in Traumatic Brain Injury: Essential or Nonessential? A Contemporary Pro-Con Review

Secondary brain injury due to raised intracranial pressure (ICP) following traumatic brain injury (TBI) has profound effects on neurological outcomes.While management of raised ICP forms the cornerstone in the management of TBI, measurement of ICP is not a uniform practice worldwide and remains a subject of debate.Invasive ICP monitoring is advocated in certain patients as per the Brain Trauma Foundation guidelines.However, some studies have shown no effect on outcomes in patients receiving ICP monitoring.ICP is now measured along with parameters that are affected by the autoregulatory status and brain oxygenation, reflecting a paradigm shift in ICP-driven management of TBI.This pro-con article aims to represent the two schools of thought and review the changes and challenges in ICP-centered approach to TBI.