Traumatic brain injury frequently causes an elevation of intracranial pressure (ICP) that could lead to reduction of cerebral perfusion pressure and cause brain ischemia. Invasive ICP monitoring is recommended by international guidelines, in order to reduce the incidence of secondary brain injury; although rare, the complications related to ICP probes could be dependent on the duration of monitoring. The aim of this manuscript is to clarify the appropriate timing for removal and management of invasive ICP monitoring, in order to reduce the risk of related complications and guarantee adequate cerebral autoregulatory control. There is no universal consensus concerning the duration of invasive ICP monitoring and its related complications, although the pertinent literature seems to show that the longer is the monitoring maintenance, the higher is the risk of technical issues. Besides, upon 72 h of normal ICP values or less than 72 h if the first computed tomography scan is normal (none or minimal signs of injury) and the neurological exam is available (allowing to observe variations and possible occurrence of new-onset pathological response), the removal of invasive ICP monitoring can be justified. The availability of non-invasive monitoring systems should be considered to follow up patients’ clinical course after invasive ICP probe removal or for substituting the invasive monitoring in case of contraindication to its placement. Recently, optic nerve sheath diameter and straight sinus systolic flow velocity evaluation through ultrasound methods showed a good correlation with ICP values, demonstrating their potential role in place of invasive monitoring or in the early weaning phase from the invasive ICP monitoring.

创伤性脑损伤经常导致颅内压 (ICP) 升高，这可能导致脑灌注压降低并导致脑缺血。国际指南推荐有创ICP监测，以减少继发性脑损伤的发生率；虽然很少见，但与 ICP 探头相关的并发症可能取决于监测的持续时间。本手稿的目的是阐明移除和管理侵入性 ICP 监测的适当时机，以降低相关并发症的风险并保证充分的脑自动调节控制。关于有创ICP监测的持续时间及其相关并发症尚无普遍共识，尽管相关文献似乎表明监测维持时间越长，技术问题的风险越高。此外，如果 ICP 值正常 72 小时或小于 72 小时，如果第一次计算机断层扫描正常（无损伤或损伤迹象最小）并且可以进行神​​经系统检查（允许观察变化和可能发生的新发病理反应） )，去除有创ICP监测是有道理的。应考虑使用非侵入性监测系统来跟踪患者在侵入性 ICP 探头移除后的临床过程，或在存在放置禁忌症的情况下替代侵入性监测。最近，通过超声方法评估的视神经鞘直径和直窦收缩期血流速度与 ICP 值具有良好的相关性，