Journal article
Continuous Monitoring of Intracranial Pressure for the Early Detection of Postoperative Hemorrhage
Japanese Journal of Neurosurgery, Vol.9(2), pp.69-74
2000
DOI: 10.7887/jcns.9.69
Abstract
Monitoring and management of intracranial pressure (ICP) are essential to modern neurosugery. ICP monitoring is beneficial in guiding the use of potentially harmful treatments such as mannitol, hyperventilation, barbiturate coma, and hypothermia. Many investigators have reported on the accuracy and reliability of ICP monitoring in the detection of cerebral herniation in the initial stage. The authors used an ICP monitoring system to detect postoperative hemorrhages in 85 patients with cerebrovascular diseases, including subarachnoid hemorrhage (SAH), intracranial hemorrhage (ICH), and arteriovenous malformation (AVM). Within 24 hours after surgery, the average ICP of 83 patients gradually rose and was lower than 10.7 ± 8.2 mmHg. In 2 patients who had postoperative bleeding ICP sharply increased by more than 30 mmHg. The first case was a 45-year-old male with a massive intracerebral hematoma (80 x 65 mm in diameter) due to a ruptured aneurysm (Hunt and Kosnik grade V). The patient underwent removal of the hematoma without angiography and clipping of the aneurysm was immediately carried out. Although ICP monitoring demonstrated less than 5 mmHg 6 hours following the operation, ICP rapidly soon thereafter exceeded 30 mmHg. An emergency CT scan revealed postoperative hemorrhage. The second case was a 33-year-old male with a huge AVM in the left occipital lobe. On the way to the intensive care unit after surgical removal of AVM, ICP was 25 mmHg. Then postoperative hemorrhage was verified on emergency CT scans. The present study demonstrates that a rapid increase of ICP by more than 25 mmHg in the early stages after surgery indicates postoperative hemorrhage. We concluded that continuous ICP monitoring after surgery is a reliable method to salvage the patient before a critical condition due to postoperative hemorrhage occurs.
Details
- Title: Subtitle
- Continuous Monitoring of Intracranial Pressure for the Early Detection of Postoperative Hemorrhage
- Creators
- Nobuya Okami - Tokyo Women's Medical UniversityHiroshi Ujiie - Tokyo Women's Medical UniversityHiroto Kawasaki - Tokyo Women's Medical UniversityTakakazu Kawamata - Tokyo Women's Medical UniversityTomokatsu Hori - Tokyo Women's Medical University
- Resource Type
- Journal article
- Publication Details
- Japanese Journal of Neurosurgery, Vol.9(2), pp.69-74
- DOI
- 10.7887/jcns.9.69
- ISSN
- 0917-950X
- eISSN
- 2187-3100
- Language
- English
- Date published
- 2000
- Academic Unit
- Neurosurgery
- Record Identifier
- 9984383305802771
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