VI. Indications for Intracranial Pressure Monitoring

Bratton, Susan L.; Chestnut, Randall M.; Ghajar, Jamshid; Hammond, Flora F. McConnell; Harris, Odette A.; Härtl, Roger; Manley, Geoffrey T.; Nemecek, Andrew; Newell, David W.; Rosenthal, Guy; Schouten, Joost W.; Shutter, Lori; Timmons, Shelly D.; Ullman, Jamie S.; Videtta, Walter; Wilberger, Jack E.; Wright, David W.

doi:10.1089/neu.2007.9990

Cited by 341 publications

(98 citation statements)

References 32 publications

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“…ICP monitoring is recommended by all available guidelines for the management of severe traumatic brain injury [24,25]. There are only a few studies available in which postoperative ICP and its relation to outcome was documented [26].…”

Section: Discussionmentioning

confidence: 99%

The Surgical Outcome of Traumatic Extra-Axial Hematomas Causing Brain Herniation in Children

et al. 2013

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Aim: The aim of this study was to assess the surgical outcome and prognostic importance of clinical and radiological data from children operated on under emergency conditions due to an extra-axial hematoma causing brain herniation. Methods: This retrospective study included 25 children operated on due to herniated traumatic extra-axial hematomas from January 2000 to December 2010. Results: Of those 25 children, 17 (68%) were diagnosed with subdural hematoma (SDH), 7 (28%) with epidural hematoma (EDH) and only 1 patient (4%) suffered from both SDH and EDH. Overall mortality from a herniated extra-axial hematoma was 44%. The mortality rate for herniated SDH patients was 52.9%, and only 1 patient died from a herniated EDH (14.2%). Low Glasgow coma scale scores at admission, high postoperative intracranial pressure (ICP) values, longer intervals from trauma to surgery, longer durations of brain herniation, the presence of intraoperative brain swelling, larger and thicker hematomas and more displacement of the midline structures and obliteration of the basal cisterns were all correlated with mortality and an unfavorable outcome. Conclusions: Brain herniation is a serious consequence of traumatic extra-axial hematomas in children, and approximately one third of these patients have the potential for a favorable outcome. We recommend postoperative ICP monitoring to predict outcome and early decompressive surgery when possible for promising results.

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Section: Discussionmentioning

confidence: 99%

The Surgical Outcome of Traumatic Extra-Axial Hematomas Causing Brain Herniation in Children

et al. 2013

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“…One of the key challenges in all ABI types is the management of raised intracranial pressure (ICP). A higher burden of intracranial hypertension, both in degree and duration, is associated with worse outcome after TBI, and consensus guidelines recommend treatment of ICP of 20 mmHg or higher [61]. Osmotic therapy has been a cornerstone of the management of intracranial hypertension for decades but its use remains controversial.…”

Section: Intracranial Pressure Controlmentioning

confidence: 99%

“…Osmotic therapy has been a cornerstone of the management of intracranial hypertension for decades but its use remains controversial. Mannitol is recommended by consensus guidelines [61], but has never been subject to a large randomized comparison and has well-known side effects. Hypertonic saline (HS) has many beneficial effects on the injured brain in addition to its osmotic action.…”

Section: Intracranial Pressure Controlmentioning

confidence: 99%

“…International consensus and evidence-based guidelines for the management of adult TBI are available [61], but evidence in pediatric TBI is relatively scarce. All major studies have excluded patients younger than 14-16 years, so there remains uncertainty about the optimal management of ICP and cerebral perfusion pressure in pediatric TBI.…”

Section: Pediatric Traumatic Brain Injurymentioning

confidence: 99%

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Year in review in Intensive Care Medicine 2013: I. Acute kidney injury, ultrasound, hemodynamics, cardiac arrest, transfusion, neurocritical care, and nutrition

et al. 2013

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“…These complications may lead to elevated intracranial pressure (ICP), either primarily through an increase in intracranial volume or secondarily through acute obstructive hydrocephalus. Reduction in elevated ICP maintaining values <20 mm Hg is the major therapeutic target to prevent potentially life-threatening cerebral hypoperfusion [1,2,3,4,5]. ICP can be monitored indirectly by cross-sectional imaging as well as directly by ventriculostomy and microtransducers [6].…”

Section: Introductionmentioning

confidence: 99%

Doppler Pulsatility Index in Spontaneous Intracerebral Hemorrhage

Kiphuth¹,

Huttner²,

Dörfler

et al. 2013

Eur Neurol

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Background and Purpose: Elevated intracranial pressure (ICP) as a result of intracerebral hemorrhage (ICH) and perihematomal edema often leads to tissue shift, which can be identified in cross-sectional imaging and presents a known predictor of functional outcome. Pulsatility indices (PIs) of the intracranial arteries as measured by transcranial Doppler sonography (TCD) may serve as surrogate parameters for ICP. This study aims to investigate whether PI correlates with ICP and midline shift and serves as a reliable predictor of functional outcome in patients with ICH. Methods: Within a 1-year period between April 2009 and April 2010, 136 patients with acute spontaneous, supratentorial ICH were admitted to our tertiary care hospital. One-hundred and twenty-four patients fulfilled the inclusion criteria and were eligible for analysis. TCD and transcranial duplex sonography were performed on admission and at least once more during hospital stay. Functional outcome was assessed 6 months after discharge. Correlation analyses, logistic regression analyses and receiver operating characteristic curves were calculated. Results: One-hundredand twenty-four patients were included in the analysis. Six-month mortality amounted to 39.5%. The ICH score and PIs of the middle cerebral artery were independent predictors of outcome 6 months after discharge. Conclusions: Early PI monitoring by TCD correlated with ICP and may be used to predict the outcome after 6 months.

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VI. Indications for Intracranial Pressure Monitoring

Cited by 341 publications

References 32 publications

The Surgical Outcome of Traumatic Extra-Axial Hematomas Causing Brain Herniation in Children

The Surgical Outcome of Traumatic Extra-Axial Hematomas Causing Brain Herniation in Children

Year in review in Intensive Care Medicine 2013: I. Acute kidney injury, ultrasound, hemodynamics, cardiac arrest, transfusion, neurocritical care, and nutrition

Doppler Pulsatility Index in Spontaneous Intracerebral Hemorrhage

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