Tóm tắt

Objectives: To identify the role of intracranial pressure (ICP) monitoring for pre- and post-decompressive craniectomy for acute subdural hematoma due to traumatic brain injury (TBI). Subjects and methods: The study was conducted on 52 patients diagnosed with subdural hematoma after TBI hospitalised in Thanh Nhan Hospital from January 2013 to December 2015. All patients were monitored ICP before and after 5 days’ decompressive craniectomy to compare pressure values before and after craniectomy and to determine the associated factors for ICP level. Results: Of total 52 the patients, 82.3% were men, with a median age of 37.5 years (range, 16 - 67 years). The average ICP measured prior to operation was 43.8 mmHg and 18.3 mmHg after surgery. Patients with ICP level ≥ 20 mmHg was associated with 34.1 times higher risk of mortality compared to those < 20 mmHg. After operation (day 1 - 4), the ICP level was linked to the reduced mortality risk from OR = 9.5 to OR = 3.4. However, the risk increased significantly in day 5 with OR = 71.0. At the discharge, the recovery rate was better in the < 20 mmHg group. Conclusion: ICP monitoring was of a great value for TBI treatment and prognosis. Patients with ICP ≥ 20 mmHg were associated with high risk of mortality compared to ICP < 20 mmHg. * Keywords: Intracranial pressure; Traumatic brain injury; Subdural hematoma.

Abstract

Objectives: To identify the role of intracranial pressure (ICP) monitoring for pre- and post-decompressive craniectomy for acute subdural hematoma due to traumatic brain injury (TBI). Subjects and methods: The study was conducted on 52 patients diagnosed with subdural hematoma after TBI hospitalised in Thanh Nhan Hospital from January 2013 to December 2015. All patients were monitored ICP before and after 5 days’ decompressive craniectomy to compare pressure values before and after craniectomy and to determine the associated factors for ICP level. Results: Of total 52 the patients, 82.3% were men, with a median age of 37.5 years (range, 16 - 67 years). The average ICP measured prior to operation was 43.8 mmHg and 18.3 mmHg after surgery. Patients with ICP level ≥ 20 mmHg was associated with 34.1 times higher risk of mortality compared to those < 20 mmHg. After operation (day 1 - 4), the ICP level was linked to the reduced mortality risk from OR = 9.5 to OR = 3.4. However, the risk increased significantly in day 5 with OR = 71.0. At the discharge, the recovery rate was better in the < 20 mmHg group. Conclusion: ICP monitoring was of a great value for TBI treatment and prognosis. Patients with ICP ≥ 20 mmHg were associated with high risk of mortality compared to ICP < 20 mmHg. * Keywords: Intracranial pressure; Traumatic brain injury; Subdural hematoma.