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Decreased risk of secondary brain herniation with intracranial pressure monitoring in patients with haemorrhagic stroke

机译：颅内压监测降低出血性中风患者继发性脑疝的风险

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Background Intracranial-pressure (ICP) monitoring is considered standard care for severe traumatic brain injury and is used frequently, but the efficacy of treatment based on monitoring in patients with hemorrhagic stroke has not been rigorously assessed. In this study, we investigated the clinical value of ICP monitoring in patients with hemorrhagic stroke. Methods We conducted a randomized, unblinded, controlled trial in which 90 patients with hemorrhagic stroke were randomly assigned to ICP monitoring or a control group. The primary outcome was a composite of incidence rate of hematoma enlargement and secondary brain herniation. The secondary outcome was neurological status assessed using the Glasgow Outcome Scale scores at 6?months post-onset. Characteristics of the patients at baseline and outcome measurements were also compared between the two groups. Results There was no significant between-group difference in the incidence of hematoma enlargement (control group, 38.6% vs. ICP monitoring group, 32.6%; P?>?0.05). The incidence rate of secondary brain herniation in the ICP monitoring group was significantly lower compared with the control group (10.9% vs. 20.5%, P?=?0.04). Six-month mortality was 6.5% in the ICP group and 9.1% in the control group (P? Conclusion The dynamic ICP value may be more sensitive and effective in preventing secondary brain herniation in patients with hemorrhagic stroke compared with guidance directed by clinical signs and radiological indicators.
机译：背景技术颅内压（ICP）监测被认为是严重外伤性脑损伤的标准治疗方法，并且经常使用，但是尚未对出血性中风患者基于监测的治疗效果进行严格评估。在这项研究中，我们调查了ICP监测在出血性中风患者中的临床价值。方法我们进行了一项随机，无盲，对照试验，将90例出血性中风患者随机分为ICP监测组或对照组。主要结局是血肿扩大和继发性脑疝的发生率的综合。次要结果是在发病后6个月使用格拉斯哥成果量表评分评估神经系统状况。还在两组之间比较了患者的基线特征和结果测量。结果血肿扩大的发生率组间无显着差异（对照组38.6％，ICP监测组32.6％; P <0.05）。 ICP监测组中继发性脑疝的发生率明显低于对照组（10.9％vs. 20.5％，P <= 0.04）。 ICP组的六个月死亡率为6.5％，对照组为9.1％（P？结论）动态ICP值与出血性脑卒中患者的临床症状和指导相比，在预防继发性脑卒中时可能更为敏感和有效。放射学指标。

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