Document Detail

Intracranial pressure following aneurysmal subarachnoid hemorrhage: monitoring practices and outcome data.
MedLine Citation:
PMID:  15679302     Owner:  NLM     Status:  MEDLINE    
OBJECT: Elevated intracranial pressure (ICP) is an important consequence of aneurysmal subarachnoid hemorrhage (SAH) that often results in decreased cerebral perfusion and secondary clinical decline. No definitive guidelines exist regarding methods and techniques for ICP management following aneurysm rupture. The authors describe monitoring practices and outcome data in 621 patients with aneurysmal SAH admitted to their neurological intensive care unit during an 8-year period (1996-2003). METHODS: A fiberoptic catheter tip probe or external ventricular drain (EVD) was used to record ICP values. The percentage of monitored patients varied, as expected, according to admission Hunt and Hess grade (p < 0.0001). Intracranial pressure monitoring devices were used in 27 (10%) of 264 Grade I to II patients, 72 (38%) of 189 Grade III patients, and 134 (80%) of 168 Grade IV to V patients. There was a strong propensity to favor transduced ventricular drains over parenchymal fiberoptic bolts, with the former used in 221 (95%) of 233 cases. This tendency was particularly strong in the poor-grade cohort, in which EVDs were placed in 99% of monitored individuals. The rates of cerebrospinal fluid infection in patients in whom ICP probes (0%) and ventricular drains (12%) were placed accorded with those in the literature. CONCLUSIONS: Following aneurysmal SAH, ICP monitoring prevalence and techniques differ with respect to admission Hunt and Hess grade and are associated with the patient's functional status at discharge.
William J Mack; Ryan G King; Andrew F Ducruet; Kurt Kreiter; J Mocco; Ahmed Maghoub; Stephan Mayer; E Sander Connolly
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2003-04-15
Journal Detail:
Title:  Neurosurgical focus     Volume:  14     ISSN:  1092-0684     ISO Abbreviation:  Neurosurg Focus     Publication Date:  2003 Apr 
Date Detail:
Created Date:  2005-01-31     Completed Date:  2006-06-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100896471     Medline TA:  Neurosurg Focus     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e3     Citation Subset:  IM    
Department of Neurological Surgery, Columbia University College of Physicians and Surgeons, New York, New York 10032, USA.
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MeSH Terms
Cohort Studies
Intracranial Aneurysm / complications,  physiopathology*,  therapy
Intracranial Hypertension / etiology,  physiopathology*,  therapy
Intracranial Pressure / physiology*
Middle Aged
Monitoring, Physiologic
Subarachnoid Hemorrhage / complications,  physiopathology*,  therapy
Treatment Outcome

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