Monitoring of severely head-injured patients during the first 24 hours.

Monitoring of severely head-injured patients is essential to optimize cereb ral haemodynamics and thus to limit intracranial hypertension and to preven t the occurrence of secondary systemic cerebral injuries. It includes conti nuous measurement of intracranial pressure, mean arterial pressure and veno us jugular oxygen saturation. Assessment of circulatory velocity in the art eries of the polygon of Willis allows identification of intracranial hypert ension, and later, a vasospasm in case of subarachnoid haemorrage. Near inf rared spectroscopy is an indirect indicator of cerebral oxygenation. This t echnique has not yet been validated. Direct tissue measurement of cerebral oxygen content is the most recently developed monitoring tool. Its clinical range of application has still to be specified. These basic monitoring tec hniques are a standard. They are essential for an undelayed and efficient t reatment of complications occurring in head trauma patients. (C) 2000 Editi ons scientifiques et medicales Elsevier SAS.