After trauma in adults, guidelines for ICP monitoring include a Glasgow Coma Scale score of 3 to 8 and an abnormal computed tomographic scan. In the presence of a normal computed tomo-graphic scan, two or more of the following should prompt moni-toring anyway: age older than 40 years, unilateral or bilateral motor posturing, or systolic blood pressure below 90 mm Hg. Patients with a Glasgow Coma Scale score greater than 8 may benefit from ICP monitoring if computed tomographic scans demonstrate significant mass lesions or treatment is required for associated injuries.