Management of intracranial hypertension with and without invasive intracranial pressure monitoring

Figure 1 Patients with clinical signs of intracranial hypertension must be submitted to a head computed tomography and ultrasound (neuro POCUS). An optic nerve sheath diameter larger than 6 mm and an elevated Pulsatility index at transcranial doppler are indicative of elevated pressure. “Tier zero” measures are initiated. In case of persistent intracranial hypertension, treatment must be escalated following the steps described in the text. CT: Computed tomography; IH: Intracranial hypertension; TCD: Transcranial doppler.