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Value of Ventricular Intracranial Pressure Monitoring for Traumatic Bifrontal Contusions
- Source :
- World Neurosurgery. 113:e690-e701
- Publication Year :
- 2018
- Publisher :
- Elsevier BV, 2018.
-
Abstract
- Objective To investigate clinical efficacy of and optimal therapeutic strategy for ventricular intracranial pressure monitoring (V-ICPM) in patients with traumatic bifrontal contusions (TBCs). Methods From 8760 patients with traumatic brain injury treated between January 2010 and January 2016, a retrospective analysis was performed on 105 patients with TBCs who underwent V-ICPM and 282 patients with TBCs who did not. All patients underwent treatment at the 101st Hospital of PLA, Wuxi, China. Rates of successful conservative treatment, decompressive craniectomy, and bifrontal craniotomy; incidence of neurologic dysfunction; length of stay; and medical expenses were compared between groups. Results Glasgow Outcome Scale was used to assess all patients during follow-up (range, 6 months to 5.5 years). There were no significant differences in prognosis between the 2 groups (P = 0.100). Compared with the patients who did not undergo V-ICPM, the V-ICPM group had a significantly better successful conservative treatment rate (64.8% vs. 47.2%, P = 0.002), decompressive craniectomy rate (8.1% vs. 22.1%, P = 0.008), and bifrontal craniotomy rate (5.7% vs. 15.6%, P = 0.01); shorter length of stay (P = 0.000); and lower medical expenses (P = 0.004). Conclusions Patients with TBCs should be strictly, closely, and dynamically observed by neurosurgery intensive care unit physicians and nurses. Patients should undergo ventricular intracranial pressure probe implantation in a timely manner. V-ICPM can help optimize treatment. Although V-ICPM did not significantly improve the prognosis of patients, it had many other advantages. V-ICPM warrants further clinical research and may be beneficial for patients with TBCs.
- Subjects :
- Adult
Male
Decompressive Craniectomy
medicine.medical_specialty
Adolescent
Intracranial Pressure
Intraoperative Neurophysiological Monitoring
Traumatic brain injury
medicine.medical_treatment
Cerebral Ventricles
law.invention
Young Adult
03 medical and health sciences
0302 clinical medicine
law
Brain Injuries, Traumatic
medicine
Humans
030212 general & internal medicine
Child
Craniotomy
Aged
Retrospective Studies
Intracranial pressure
Aged, 80 and over
business.industry
Glasgow Outcome Scale
Brain Contusion
Middle Aged
medicine.disease
Intensive care unit
Surgery
Intracranial pressure monitoring
Female
Decompressive craniectomy
Neurology (clinical)
Neurosurgery
business
030217 neurology & neurosurgery
Follow-Up Studies
Subjects
Details
- ISSN :
- 18788750
- Volume :
- 113
- Database :
- OpenAIRE
- Journal :
- World Neurosurgery
- Accession number :
- edsair.doi.dedup.....ac6a325a423a23115811070dd74830e6