Two hundred and six patients with severe head injury (Glasgow Coma Scale of 8 points or less after nonsurgical resuscitation on admission), managed at Intensive Care Unit-Hospital das Clínicas - Universidade Estadual de Campinas were prospectively analysed. All patients were assessed by CT scan and 72 required neurosurgical intervention. All patients were continuously monitored to evaluate intracranial pressure (ICP) levels by a subarachnoid device (11 with subarachnoid metallic bolts and 195 with subarachnoid polyvinyl catheters). The ICP levels were continuously observed in the bedside pressure monitor display and their end-hour values were recorded in a standard chart. The patients were managed according to a standard protocol guided by the ICP levels. There were no intracranial haemorrhagic complications or hematomas due the monitoring method. Sixty six patients were punctured by lateral C1-C2 technique to assess infectious complications and 2 had positive cerebrospinal fluid samples for Acinetobacter sp. The final results measured at hospital discharge showed 75 deaths (36,40%) and 131 (63,60%) survivors. ICP levels had significantly influenced the final results (p<0,001). The subarachnoid method to continuously assess the ICP levels was considered aplicable, safe, simple, low cost and useful to advise the management of the patients. The ICP record methodology was practical and useful. Despite the current technical advances the subarachnoid method was considered viable to assess the ICP levels in severe head injury.594895900Teasdale, G., Jennet, B., Assessment of coma and impaired consciousness: A practical scale (1974) Lancet, 2, pp. 81-84Dantas Filho, V.P., (1999) Aspectos Técnicos da Monitorização da Pressão Intracraniana Pelo Método Subaracnóideo e Análise dos Fatores Que Influenciaram a Evolução de 206 Pacientes Com Traumatismo Craniencefálico Grave, , Tese Unicamp. CampinasDantas Filho, V.P., Falcão, A.L.E., Monitorização da pressão intacraniana (1991) Monitorização Invasiva Em Uti. Campinas: Scan, pp. 131-141. , Terzi RGG, Araújo S (eds)Falcão, A.L.E., Dantas Filho, V.P., Saraiva, J.F.K., Sardinha, L.A.C., Araújo, S., Terzi, R.G.G., Bedside ICP monitoring in head trauma patients by using a simple, safe and low cost methodology (1992) Clin Intens Care, (3 SUPPL. 112)Andrade, A.F., Teixeira, M.J., Bacheschi, L.A., Medida contínua da pressão intracraniana com parafusos: Modificação técnica (1983) Arq Bras Neurocirurg, 2, pp. 143-148Cruz, J., Relevância da otimização ventilatória em hipertensão intracraniana aguda: Uma abordagem clínica-fisiológica-terapêutica (1995) Arq Neuropsiquiatr, 53, pp. 131-140Falcão, A.L.E., Dantas Filho, V.P., Sardinha, L.A.C., Highlighting intracranial pressure monitoring in patients with severe acute brain trauma (1995) Arq Neuropsiquiatr, 53, pp. 390-394Falcão, A.L.E., Araújo, S., Dragosavac, D., Hemometabolismo cerebral: Variações na fase aguda do coma traumático (2000) Arq Neuropsiquiatr, 58, pp. 877-882Flitter, M.A., Techniques of intracranial pressure monitoring (1980) Clin Neurosurg, 28, pp. 547-563Yano, M., Kobayashi, S., Otsuka, T., Useful ICP monitoring with subarachnoid catheter method in severe head injuries (1988) J Trauma, 28, pp. 476-480Mendelow, A.D., Rowan, J.O., Murray, L., Kerr, A.E., A clinical comparison of subdural screw pressure measurements with ventricular pressure (1983) J Neurosurg, 58, pp. 45-50Dearden, N.M., McDowall, D.G., Gibson, R.M., Assessment of Leeds device for monitoring intracranial pressure (1984) J Neurosurg, 60, pp. 123-129Mollman, H.D., Rockswold, G.L., Ford, S.E., A clinical comparison of subarachnoid catheters to ventriculostomy and subarachnoid bolts: A prospective study (1988) J Neurosurg, 68, pp. 737-741Landy, H.J., Villanueva, P.A., An improved subarachnoid screw for intracranial pressure monitoring: Technical note (1984) J Neurosurg, 61, pp. 606-608Feldman, Z., Narayan, R.K., Intracranial pressure monitoring: Techniques and pitfalls (1993) Head Injury, 3, pp. 247-274. , Cooper PR (ed). Baltimore: Williams & WilkinsBecker, D.P., Gade, G.F., Young, H.F., Feuerman, T.F., Diagnosis and treatment of head injury in adults (1990) Neurological Surgery, 3, pp. 2017-2148. , Youmans JR (ed). Philadelphia: SaundersWilkinson, H.A., Intracranial pressure (1990) Neurological Surgery, 3, pp. 661-695. , Youmans JR (ed). Philadelphia: SaundersArst, D.B., Silver, M., Lahey, W.J., The use of vinyl plastic tubing in recording pressure phenomena (1951) Am Heart J, 42, pp. 746-748Rushmer, R.F., Biomechanics and biomaterials (1972) Medical Engineering: Projections for Health and Care Delivery, pp. 293-320. , Rushmer RF (ed). New York: Academic PressWilkinson, H.A., The intracranial pressure-monitoring cup catheter: Technical note (1977) Neurosurgery, 1, pp. 139-141Mendes, M., Moore, P., Wheeler, C.B., Winn, H.R., Rodeheaver, G., Susceptibility of brain and skin to bacterial challenge (1980) J Neurosurg, 52, pp. 772-775Lundberg, N., Continuous recording and control of ventricular fluid pressure in neurosurgical practice (1960) Acta Psychiat Neurol Scand, 36 (149 SUPPL.)Marmarou, A., Anderson, R.L., Ward, J.D., Impact of ICP instability and hypotension on outcome in patients with severe head trauma (1991) J Neurosurg, 75 (SUPPL.), pp. S59-S66Luerssen, T.G., Marshall, L.F., The medical management of head injury (1990) Handbook of Clinical Neurology: Head Injury, 57, pp. 207-247. , Vinken PJ, Bruyn GW, Klawans HL, Braakman R (eds). Amsterdame: Elsevier, revised series 13Wilkinson, H.A., Yarzebski, J., Wilkinson, E.C., Anderson, F.A., Erroneous measurement of intracranial pressure caused by simultaneous ventricular drainage: A hydrodynamic model study (1989) Neurosurgery, 24, pp. 348-354Crutchfield, J.S., Narayan, R.K., Robertson, C.S., Michael, L.H., Evaluation of a fiberoptic pressure monitor (1990) J Neurosurg, 72, pp. 482-487Barlow, P., Mendelow, A.D., Lawrence, A.E., Barlow, M., Rowan, J.O., Clinical evaluation of two methods of subdural pressure monitoring (1985) J Neurosurg, 63, pp. 578-582Villanueva, P.A., Simplified technique for subdural pressure monitoring: Technical note (1985) Neurosurgery, 16, pp. 238-240Sugiura, K., Hayama, N., Tachisawa, T., Baba, M., Takisawa, H., Intracranial pressure monitoring by a subdurally placed silicone catheter: Technical note (1985) Neurosurgery, 16, pp. 241-244Zivin, J.A., Lateral cervical puncture: An alternative to lumbar puncture (1978) Neurology, 28, pp. 616-618Stephens, J.L., Peacock, J.E., Uncommon infections: Eye and central nervous system (1993) Prevention and Control of Nosocomial Infections, 2, pp. 746-775. , Wenzel RP (ed). Baltimore: Williams & WilkinsNarayan, R.K., Kishore, P.R.S., Becker, D.P., Intracranial pressure: To monitor or not to monitor? A review of our experience with severe head injury (1982) J Neurosurg, 56, pp. 650-659Mayhall, C.G., Archer, N.H., Lamb, A., Ventriculostomy-related infections: A prospective epidemiologic study (1984) N Engl J Med, 310, pp. 553-559Aucoin, P.J., Kotilainen, H.R., Gantz, N.M., Davidson, R., Kellogg, P., Stone, B., Intracranial pressure monitors: Epidemiologic study of risk factors and infections (1986) Am J Med, 80, pp. 369-376Turner, H.B., Anderson, R.L., Ward, J.D., Young, H.F., Marmarou, A., Comparison of nurse and computer recording of ICP in head injured patients (1988) J Neurosci Nurs, 20, pp. 236-239