INTRACRANIAL PRESSURE MONITORING IN TRAUMATIC BRAIN INJURY: INDICATIONS AND IMPACT ON OUTCOMES
DOI:
https://doi.org/10.36557/2674-9432.2026v5n3p1617-1628Resumo
Severe traumatic brain injury remains one of the leading causes of neurological morbidity and mortality, particularly due to secondary injuries associated with intracranial hypertension, cerebral hypoperfusion, hypoxia, edema, and brain herniation. In this context, intracranial pressure monitoring has been incorporated into neurocritical care as a strategy to identify potentially reversible physiological changes early and to guide individualized therapeutic interventions. This narrative review aimed to analyze the main indications for intracranial pressure monitoring in patients with traumatic brain injury and to discuss its impact on clinical and functional outcomes. The search strategy was guided by the PICo framework, considering patients with moderate to severe traumatic brain injury as the population, intracranial pressure monitoring as the phenomenon of interest, and hospital and neurocritical care settings as the context. Publications between 2019 and 2026 were prioritized, including guidelines, consensus statements, reviews, multicenter observational studies, and investigations on multimodal monitoring. The literature indicates that intracranial pressure monitoring is especially recommended in patients with severe traumatic brain injury, significant impairment of consciousness, tomographic findings suggestive of mass lesions, cerebral edema, cisternal compression, or signs of neurological deterioration. Although its isolated impact on mortality and functional recovery remains heterogeneous across studies, monitoring appears to provide greater value when integrated into structured protocols, stepwise algorithms, and multimodal strategies, such as cerebral oxygenation and cerebral perfusion pressure assessment. It is concluded that intracranial pressure monitoring should not be viewed as an isolated therapeutic intervention, but rather as a decision-support tool within contemporary neurocritical care.
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Copyright (c) 2026 Leonardo Silva Canales, Rodolfo de Oliveira Medeiros, Cristiano Machado Galhardi, Ana Laura Jorge Manzini, Gabriel Francisco Alves, Ligiane Aparecida Barboza de Araújo Brant, Ana Laura Santos Golinelli, Enzo Carone Carloti, Lara Carmelin Brasil, Gabriela Pinheiro Bravo, Henrique Felipin Da Silva Evangelisa, Diego Durante de Oliveira
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