1. The Course of Intracranial Pressure in Traumatic Brain Injury
- Author
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Rosette Bremmer, Joukje van der Naalt, Michiel Wagemakers, Joost G. Regtien, Bauke M. de Jong, and Molecular Neuroscience and Ageing Research (MOLAR)
- Subjects
Hematoma, Epidural, Cranial ,Male ,Severe head injury ,Neurology ,Intracranial Pressure ,ICP profiles ,IMPACT ,Glasgow Outcome Scale ,Critical Care and Intensive Care Medicine ,GUIDELINES ,Outcome (game theory) ,Disability Evaluation ,Traumatic brain injury ,SCALE ,Intracranial pressure ,Outcome ,Neurologic Examination ,integumentary system ,musculoskeletal, neural, and ocular physiology ,Middle Aged ,Prognosis ,humanities ,Survival Rate ,Hematoma, Subdural ,CEREBRAL PERFUSION-PRESSURE ,Anesthesia ,Intracranial pressure (ICP) ,Female ,Opening pressure ,Adult ,medicine.medical_specialty ,Critical Care ,Young Adult ,medicine ,MANAGEMENT ,Humans ,Glasgow Coma Scale ,Cerebral perfusion pressure ,CT-scan characteristics ,Retrospective Studies ,HYPERTENSION ,business.industry ,Persistent Vegetative State ,ADULTS ,SEVERE HEAD-INJURY ,medicine.disease ,nervous system diseases ,Brain Injuries ,Time course ,PATTERNS ,Neurology (clinical) ,Tomography, X-Ray Computed ,business - Abstract
One of the predictive factors of outcome in traumatic brain injury is high intracranial pressure (ICP). Recently, the time course of ICP has been described but few data are available on the relation of these ICP profiles and outcome. The aim of this study is to investigate the relation of the time course of ICP with CT-findings and outcome.Retrospective analysis of prospectively collected data of 246 patients with traumatic brain injury admitted to the neurosurgical intensive care unit.Early rise in ICP (within the first 2 days) was present in 32%, an intermediate rise (between days 3 and 5) in 34% and a late rise (after day 5) in 34% of patients. Half of the patients with a normal opening pressure (76%) developed intermediate or late ICP rise profiles. More mass lesions and sub/epidural hematomas were present in the late rise group. Patients with a late ICP rise required significant more intensive treatment (65% vs. 37 and 33%) when compared to the early and intermediate rise groups. In multiple regression analysis both ICP profiles and extracranial hematomas were related to outcome. With late ICP rise more unfavorable outcome (46 vs. 17%, P During ICP monitoring different ICP profiles are present over time. These profiles are related to CT-characteristics and outcome. The importance of early and late monitoring of ICP is underlined.
- Published
- 2010
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