Intracranial pressure (ICP) monitoring is now viewed as integral to the clinical care of many life-threatening brain insults, such as severe traumatic brain injury, subarachnoid hemorrhage, and malignant stroke. It serves to warn of expanding intracranial mass lesions, to prevent or treat herniation events as well as pressure elevation which impedes nutrient delivery to the brain. It facilitates the calculation of cerebral perfusion pressure (CPP) and the estimation of cerebrovascular autoregulatory status. Despite advancements in our knowledge emanating from a half century of experience with this technology, important controversies remain related even to fundamental aspects of ICP measurements, including indications for monitoring, ICP treatment thresholds, and management of intracranial hypertension. Here, we review the history of ICP monitoring, the underlying pathophysiology as well as current perspectives on why, when and how ICP monitoring is best used. ICP is typically assessed invasively but a number of emerging, non-invasive technologies with inherently lower risk are showing promise. In selected cases, additional neuromonitoring can be used to assist in the interpretation of ICP monitoring information and adapt directed treatment accordingly. Additional efforts to expand the evidence base relevant to ICP monitoring, related technologies and management remain a high priority in neurosurgery and neurocritical care.

颅内压 (ICP) 监测现在被视为许多危及生命的脑损伤（如严重创伤性脑损伤、蛛网膜下腔出血和恶性中风）临床护理的组成部分。它用于警告扩大的颅内肿块病变，以预防或治疗疝气事件以及阻碍营养输送到大脑的压力升高。它有助于计算脑灌注压 (CPP) 和估计脑血管自动调节状态。尽管我们的知识在半个世纪的经验中取得了进步，但重要的争议仍然与 ICP 测量的基本方面有关，包括监测的适应症、ICP 治疗阈值和颅内高压的管理。在这里，我们回顾ICP监测的历史，潜在的病理生理学以及当前关于为什么、何时以及如何最好地使用 ICP 监测的观点。ICP 通常采用侵入式评估，但许多具有固有较低风险的新兴非侵入性技术正在显示出前景。在选定的病例中，可以使用额外的神经监测来帮助解释 ICP 监测信息并相应地调整定向治疗。扩大与 ICP 监测、相关技术和管理相关的证据基础的额外努力仍然是神经外科和神经重症监护的高度优先事项。额外的神经监测可用于协助解释 ICP 监测信息并相应地调整定向治疗。扩大与 ICP 监测、相关技术和管理相关的证据基础的额外努力仍然是神经外科和神经重症监护的高度优先事项。额外的神经监测可用于协助解释 ICP 监测信息并相应地调整定向治疗。扩大与 ICP 监测、相关技术和管理相关的证据基础的额外努力仍然是神经外科和神经重症监护的高度优先事项。