Preliminary clinical study on cisternal intracranial pressure monitoring after craniotomy in traumatic brain injury

Abstract

Objective To explore the feasibility and accuracy of cisternal intracranial pressure (ICPc) monitoring after craniotomy in traumatic brain injury (TBI). Methods Four TBI patients underwent evacuation of hematoma were enrolled from May 2019 to July 2020. Ventriculostomy and cisternotomy were performed besides evacuation, and intracranial pressure (ICP) were monitored via the methods of extraventricular drainage (EVD) and cisternal drainage (CD) simultaneously for 7d after craniotomy. The correlation and consistency between ICPc and ventricular ICP (ICPv) were observed. Results The mean values of ICPv were (14.72±5.98), (11.10±4.49), (27.29±6.06) and (12.63±5.36) mm Hg, respectively. The mean values of ICPc were (14.32±5.44), (11.20±4.36), (25.46±5.00) and (12.46±5.21) mm Hg, respectively. The correlation coefficients were 0.977 (P=0.000), 0.961 (P=0.000), 0.892 (P=0.000) and 0.970 (P = 0.000), respectively. Using Bland⁃Altman consistency evaluation, the mean ICP difference between ICPv and ICPc was (0.21±1.36)mmHg, 95%LoA was ⁃2.440-2.870 (P=0.003). Conclusions ICPc and ICPv have good linear correlation and consistency. ICP monitoring through the method of cisternotomy and drainage can be applied to the clinical management of patients with TBI,and is likely to become an alternative method for ICPv. DOI：10.3969/j.issn.1672⁃6731.2020.07.007

Keywords

• brain injuries, traumatic
• intracranial pressure
• cerebrospinal fluid
• drainage