This book contains the papers delivered at the Fourth International Symposium on Intracranial Pressure, held at Williamsburg, Virginia, USA, June 10-14, 1979. Divided into 12 sessions, they reflect the most recent developments in areas such as head injuries, pressure volume studies, cerebrovascular complications, intracranial hemor rhage, brain edema, systemic factors and infectious processes, data recording and analysis, CSF formation and absorption, hydroce phalus, clinical aspects of ICP monitoring, anesthesia and intra cranial pressure, treatment with barbiturates and steroids, and os motherapy. The book concludes with a summary of the present state-of-the-art in the field as a whole by Dr. Langfitt. There were two innovations at this Symposium. The first of these was poster sessions, the second, breakfast seminars. This volume contains all papers read plus all those presented as posters, and for this reason contains more pages than the three previous volumes. The organizers wish to thank the Advisory Committee for the work done in paper selection and focus of the Conference. Appreciation is also given to the Chairmen and Co-chairmen of the sessions for the preparation of summary statements. Manuscript preparation was performed by Ms. Lucille Browne, and gratitude is expressed to her. The next Symposium, the Fifth International Conference on ICP, will be held in Japan in 1982. We also wish to acknowledge the technical help of Springer-Verlag and their celerity in producing this volume. The Editors VII Contents Session I. Head Injury Chairman: D. P. BECKER; Co-chairman: I. PAPO 3 Summary . . . . . . . . . . . ..

Since the early days of neurosurgery the management of patients with intracranial hypertension has formed part of the day-to-day routine of the neurosurgeon. The introduction of modem techniques for the clinical monitoring of the intracranial pressure (ICP) meant a firmer basis for the diagnosis and treatment of these patients but it also started a new research boom in the pathophysiology of ICP, and its integration with the intracranial dynamics and metabolism of the brain. This development was clearly demonstrated at the first ICP symposium which was most successfully arranged in 1972 by Hermann Dietz and Mario Brock at the Medizinische Hochschule of Hannover. The widespread interest in ICP problems which was so obviously demonstrated during this meeting evoked the idea that further ICP symposia might be warranted. At a final conference the organizers and members of the advisory board agreed that a second ICP symposium should be arranged two years later, and suggested that it should be held in Lund. This volume contains the papers presented at the Second ICP Symposium held in Lund on June 17-19, 1974. A total of 132 papers were submitted. 102 were accepted and included in the abstract volume which was issued to all participants beforehand. The selection was made by the organizing committee in co-operation with the advisory board and the chairmen.

The papers presented at the Third International Symposium on Intracranial Pressure that was held at the University of Groningen. June 1-3, 1976 are brought together in this volume. After the successful meetings in Hannover and Lund the feeling of the Advisory Board was. that the third meeting should have more clinical implications. and therefore 7 out of the 10 Sessions deal with clinical problems. That there is still a growing interest in the problems of the intracranial pressure appears from the fact that 152 papers were submitted. Unfortunately only 56 could be read. due to lack of time. The selection was made by the members of the Advisory Board. It is a pity that so many good papers had to be rejected because they did not fit in the program. It was decided in a meeting of chairmen and co-chairmen during the symposium that the next congress will take place in 1979. to keep away from the CBF-meeting in June 1977 in Copenhagen and the "Brain-Edema" meeting in 1979 in Bethesda. This fourth symposium will be held in Williamsburg (USA) and prepared by Donald P. Becker. Douglas Miller. Gerald M. Hochwald and Kenneth Shulman.

This volume contains papers presented at the Fifth International Symposium on Intra cranial Pressure held on May 30-June 3,1982, in Tokyo, Japan. The Symposium has continued to grow since it began in 1972, and this year it was comprised 121 oral and 46 poster presentations. This considerable number was chosen from the more than 216 abstracts that were received, which made the selection process very difficult. We would like to thank the Program Committee for their efforts. One hundred and fifty-one of the manuscripts are printed here. The classic papers, short communications, and the presentations for the poster sessions here appear together under their appropriate topic heading. There were eleven sessions which spanned the most basic scientific descriptions of ICP dynamics to the most recent clinical advances and debate. Also included are the seven special seminars given by the invited speakers. These spe cial seminars were an innovation at this symposium as a means of reviewing the major aspects and history and of projecting the future directions of this expanding field. The organizers wish to thank the Advisory Committee for their guidance and focus, and to express their appreciation to everyone who contributed to the success of this meeting - to the Chairmen and Co-chairmen, to all of the members and participants, and not least of all to our executive staff who worked behind the scenes. We also wish to acknowledge our gratitude to Springer-Verlag for their technical aid and for their prompt publication of this volume.

The pioneering work by Pierre Janny and Nils Lundberg added a new tool to the investigative armamentarium of the neurosurgeon: continuous monitor ing of intracranial pressure (ICP). A small group of basic and clinical sci entists recognized the importance of this method and in 1972 an International Symposium was organized by Mario Brock in Hannover, Germany. The workers "of the first hour" had high expectations and thought that the problem of intracranial hypertension could finally be dealt with. The Symposium con tinued to grow during subsequent meetings in Lund (1974), Groningen (1976) and Williamsburg (1979). However, the advent of the modern imaging tech niques of CT and MRI have dramatically changed the scene in clinical neurology and neurosurgery. These new methods as well as other monitoring techniques have put ICP in its proper place as just one of the many aspects, albeit an important one, in the management of patients with intracranial space-occupying lesions. The symposia in Tokyo (1982), Glasgow (1985) and Ann Arbor (1988) confirmed the steady interest in ICP recording, both as a research tool and as a clinical method. and yielded many new developments in the field of ICP. This book comprises the proceedings of the Eighth International Symposium on Intracranial Pressure that was held in Rotterdam, The Netherlands, from June 16th to 20th, 1991.