Intracranial pressure (ICP) monitoring easily can be considered a standard, normal, or even expected neuromonitor in disease states with pathophysiology that includes intracranial hypertension. This is because unless ICP is monitored, real-time changes in ICP can be neither detected nor treated. The anticipated benefit of ICP monitoring is that treating increased ICP results in improved patient-level outcomes (1). Despite the theoretical advantage, however, this technology has failed to gain universal traction even in disease states, such as traumatic brain injury, in which intracranial hypertension is common (2). Potential reasons for this include lack of operator availability and absence of demonstrated outcome benefit with ICP use (3) and the focal monitoring nature of the device. In this regard, although some of us may claim that the lack of ICP monitoring for the brain is analogous to the lack of a glucometer for detecting hyperglycemia or the lack of a pulse oximeter for detecting hypoxemia, we have to acknowledge that, unlike with ICP monitoring, these other monitoring devices capture "global/systemic" changes.
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