Significance of Intracranial Pressure Monitoring in Early Surgery for Poor-Grade Aneurysm Patients
Journal of Korean Neurosurgical Society
;
: 425-429, 2001.
Artículo
en Coreano
| WPRIM
| ID: wpr-168594
ABSTRACT
OBJECTIVE:
Patients with poor grade aneurysm usually present with increased intracranial pressure(ICP), even those without an intracranial clot. Based on this fact, the present study investigated a significance of intracranial pressure monitoring in those patients. PATIENTS ANDMETHODS:
A total of 60 patients with Hunt and Hess Grade IV(50 patients) or V(10 patients) were treated for aneurysmal subarachnoid hemorrhage(SAH) during a 3-year-period, and intraparenchymal ICP was measured in the majority, immediately after arrival to the emergency room. Early surgery including intraoperative ventriculostomy was undertaken within 3 days after SAH. An ultraearly surgery was performed without preceding angiogram or ICP monitoring in patients with large sylvian hematomas, highly suggestive of middle cerebral artery aneurysm. Outcomes were assessed by the Glasgow Outcome Scale(GOS) at 6 months.RESULTS:
In overall, favorable outcome(GOS scores 1-2) was seen in 27(54.0%) of admission Grade IV and 1(10.0%) of admission Grade V patients. Of the 38 surgical patients with preoperative ICP monitorings, 25 patients (80.6%) exhibiting ICP values of less than 40mmHg showed favorable outcome, however, no patients with ICP values above 40mmHg recovered(Fisher's exact test, p=0.0001).CONCLUSION:
It is concluded that a preoperative ICP above 40mmHg before ventriculostomy indicate significant vital brain destruction as intractable intracranial hypertension, and Grade IV patients at admission with an ICP below 40mmHg can be of benefit from early surgical intervention while Grade V patients still remains unfavorable.
Texto completo:
Disponible
Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Encéfalo
/
Ventriculostomía
/
Presión Intracraneal
/
Aneurisma Intracraneal
/
Hipertensión Intracraneal
/
Servicio de Urgencia en Hospital
/
Hematoma
/
Aneurisma
Límite:
Humanos
Idioma:
Coreano
Revista:
Journal of Korean Neurosurgical Society
Año:
2001
Tipo del documento:
Artículo
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