Intractable intracranial hypertension is a nerve wrecking clinical challenge which
is associated with high morbidity and mortality. Barbiturate coma therapy (BCT) is
one of the recommended options for such a challenge but is associated with its own
set of complications. Multimodality monitoring is a new advent in neurocritical care
and provides a new vision to judiciously cater to such challenges. We hereby report
a case of successfully treating intractable intracranial hypertension after maximal
possible surgical decompression and evidence of well-formed cerebral ischaemic zones
with intracranial multimodality monitoring guided BCT. The positive outcome was to
the extent of almost complete reversal of cerebral ischaemic zones and return to normal
life schedule.
Keywords
Barbiturate coma therapy - cerebral ischaemia - intractable intracranial hypertension
- multimodality monitoring - transcranial Doppler - traumatic brain injury
