Intracranial pressure measurement in a patient undergoing hemodialysis and peritoneal dialysis.

Control of changes in the intracranial pressure in patients who have suffered brain injury is essential in preventing further neurological deterioration. In a patient requiring dialysis with intracerebral bleeding, intracranial pressure was measured directly during hemodialysis and peritoneal dialysis. This provided the opportunity to provide therapeutic maneuvers to control the increases in intracranial pressure occurring during hemodialysis. Dialytic changes in intracranial pressure were best prevented by peritoneal dialysis. When hemodialysis is necessary, therapy with osmotic agents to minimize the osmotic gradient between the CSF and plasma urea was most effective in preventing directly measured changes in the intracranial pressure.