Journal of Cerebrovascular and Endovascular Neurosurgery

Korean Society of Cerebravascular Surgeons (대한뇌혈관외과학회)
권호 표지

ICP Trend in Massive ICH Patients After Decompressive Craniectomy

뇌실질내 출혈 환자에서 감압 두개골 절제술 후 두개강 내압 변화 양상

  • Lee, Cheol-Hyoun (Department of Neurosurgery, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, College of Medicine) ;
  • Yoo, Do-Sung (Department of Neurosurgery, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, College of Medicine) ;
  • Huh, Pil-Woo (Department of Neurosurgery, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, College of Medicine) ;
  • Cho, Kyoung-Suck (Department of Neurosurgery, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, College of Medicine) ;
  • Kang, Suck-Gu (Department of Neurosurgery, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, College of Medicine) ;
  • Park, Chun-Kun (Department of Neurosurgery, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, College of Medicine)
  • 이철현 (가톨릭대학교 의정부성모병원 신경외과) ;
  • 유도성 (가톨릭대학교 의정부성모병원 신경외과) ;
  • 허필우 (가톨릭대학교 의정부성모병원 신경외과) ;
  • 조경석 (가톨릭대학교 의정부성모병원 신경외과) ;
  • 강석구 (가톨릭대학교 의정부성모병원 신경외과) ;
  • 박춘근 (가톨릭대학교 의정부성모병원 신경외과)
  • Published : 2009.09.30

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Abstract

Objective : Massive intracerebral hemorrhage (ICH) is devastating neurosurgical disease. Decompression surgery has been performed to manage the uncontrolled increased intracranial pressure and good clinical result has been reported. Authors analyze the ICP trend after the decompression surgery and report the clinical usefulness. Methods : Thirty patients data with massive ICH were analyzed retrospectively. Surgical indication was constantly followed in these patient ; Glasgowcoma scale score less than 8, midline shift more than 6 mm on brain CT. In all patients ventricular puncture was done before the decompression and monitored the ventricular pressure changes during and after the surgery. Results : In massive ICH patients, the ICP was maintained in physiological range if the hematoma was removed more than 80%. And when we tried additional therapies like hypothermia or coma therapies in another group, the ICP was elevated at the time of the additional therapy. Conclusion : From this study, if the ICH removed more than 80% and The ICP was not exceed 20 mmHg during the first post-operation day, the ICP hardly exceed 20 mmHg after than. Authors thought that decompression surgery is not an essential treatment for the massive ICH patient if their hematoma removed enough.

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