Size of Hematoma and Time Course of Intracranial Pressure in Patients with Hypertensive Intracerebral Hemorrhage

Introduction: The role of N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with hypertensive intracerebral hemorrhage (HICH) is poorly understood. This study aimed to investigate the secretion pattern of NT-proBNP in patients with HICH and to assess its relationship with hematoma size, hyponatremia, and intracranial pressure (ICP). Methods: This prospective study enrolled 147 isolated patients with HICH. Blood samples were obtained from each patient, and values of serum NT-proBNP, hematoma size, blood sodium, and ICP were collected for each patient. Results: The peak-to-mean concentration of NT-proBNP was 666.8 ± 355.1 pg/mL observed on day 4. The NT-proBNP levels in patients with hematoma volume >30 mL were significantly higher than those in patients with hematoma volume <30 mL ( P < .05). In patients with severe HICH, the mean concentration of NT-proBNP was statistically higher than that in patients with mild–moderate HICH ( P < .05), and the mean level of NT-proBNP in hyponatremia group was significantly higher than that in normonatremic group ( P < .05). In addition, the linear regression analysis indicated that serum NT-proBNP concentrations were positively correlated with ICP ( r = .703, P < .05) but negatively with blood sodium levels only in patients with severe HICH ( r = −.704, P < .05). The serum NT-proBNP levels on day 4 after admission were positively correlated with hematoma size ( r = .702, P < .05). Conclusion: The NT-proBNP concentrations were elevated progressively and markedly at least in the first 4 days after HICH and reached a peak level on the fourth day. The NT-proBNP levels on day 4 were positively correlated with hematoma size. There was a notable positive correlation between plasma NT-proBNP levels and ICP in patients with severe HICH. Furthermore, only in patients with severe HICH, the plasma NT-proBNP levels presented a significant correlation with hyponatremia, which did not occur in patients with mild–moderate HICH.

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Advantages of Small Bone-Window Craniotomy Under Microscope Combined Postoperative Intracranial Pressure Monitoring in the Treatment of Hypertensive Intracerebral Hemorrhage

Journal of Craniofacial Surgery ◽

10.1097/scs.0000000000006986 ◽

2020 ◽

Vol 32 (1) ◽

pp. e77-e80

Author(s):

Donghai Men ◽

Zixiong Huang ◽

Yanqing Yin ◽

Weichuan Wu ◽

Wensheng Li ◽

...

Keyword(s):

Intracranial Pressure ◽

Intracerebral Hemorrhage ◽

Intracranial Pressure Monitoring ◽

Pressure Monitoring ◽

Bone Window ◽

Hypertensive Intracerebral Hemorrhage ◽

Small Bone

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Time Course of the Dynamics of Cerebrospinal Fluid Circulation in Hypertensive Intracerebral Hemorrhage

Neurologia medico-chirurgica ◽

10.2176/nmc.24.240 ◽

1984 ◽

Vol 24 (4) ◽

pp. 240-244 ◽

Cited By ~ 1

Author(s):

Yasutaka MAEDA ◽

Mamoru TANEDA

Keyword(s):

Cerebrospinal Fluid ◽

Intracerebral Hemorrhage ◽

Time Course ◽

Fluid Circulation ◽

Cerebrospinal Fluid Circulation ◽

Hypertensive Intracerebral Hemorrhage

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Clinical Application of ICP Monitoring Based on FVEP in Treatment of Patients with Hypertensive Intracerebral Hemorrhage

10.21203/rs.3.rs-29768/v1 ◽

2020 ◽

Author(s):

Fangping Yu ◽

Zhao Ying-chun ◽

Zhang Yu ◽

Luan Xing-hua ◽

Wu Ying

Keyword(s):

Intracranial Pressure ◽

Intracerebral Hemorrhage ◽

Lumbar Puncture ◽

Statistical Significance ◽

Control Group ◽

Monitoring Technology ◽

Urea Nitrogen ◽

Monitoring Group ◽

Hypertensive Intracerebral Hemorrhage ◽

Experimental Group

Abstract ObjectiveTo investigate the application value of flash visual evoked potential (FVEP) in the monitoring of the noninvasive intracranial pressure (nICP) in patients with hypertensive intracerebral hemorrhage (HICH).MethodsOne hundred and two patients with HICH were randomly divided into FVEP nICP monitoring group (experimental group) and the non-monitoring group (control group). The experimental group were examined lumbar puncture immediately after intracranial pressure was monitored by FVEP. Mannitol was used to dehydration treatment of intracranial hypertension patients. The serum concentrations of creatinine and urea nitrogen were recorded to assess the renal function. Using the mannitol usage to evaluate the value of FVEP nICP monitoring techniques in guiding the adjustment of dehydrating agent. The Glasgow prognosis scores (GOS) were evaluated for patients' prognosis between two groups. ResultsThere was no statistical significance between FVEP nICP measurement and lumbar puncture intracranial pressure measurement (195.76 ±13.24 mmH2O vs 197.04 ±11.98 mmH2O, P>0.05). The use of mannitol in the experimental group was significantly lower than that in the control group (P< 0.05), and the serum creatinine and urea nitrogen concentrations in the two groups were not statistically significant (P> 0.05). The cure rate of the experimental group was higher than that of the control group (χ2=3.889, P=0.048). ConclusionFVEP nICP monitoring technology could replace invasive intracranial pressure monitoring technology in monitoring intracranial pressure for HICH patients. The application of FVEP nICP technique can reduce the dosage of dehydrating mannitol and improve the prognosis of patients with HICH.

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Intracranial pressure time course in primary intracerebral hemorrhage

Neurosurgery ◽

10.1097/00006123-197906000-00002 ◽

1979 ◽

Vol 4 (6) ◽

pp. 504???11 ◽

Cited By ~ 1

Author(s):

I Papo ◽

P Janny ◽

G Caruselli ◽

G Colnet ◽

A Luongo

Keyword(s):

Intracranial Pressure ◽

Intracerebral Hemorrhage ◽

Time Course ◽

Pressure Time

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Effect of Robot-Assisted Neuroendoscopic Hematoma Evacuation Combined Intracranial Pressure Monitoring for the Treatment of Hypertensive Intracerebral Hemorrhage

Frontiers in Neurology ◽

10.3389/fneur.2021.722924 ◽

2021 ◽

Vol 12 ◽

Author(s):

Shiqiang Wu ◽

Heping Wang ◽

Junwen Wang ◽

Feng Hu ◽

Wei Jiang ◽

...

Keyword(s):

Intracranial Pressure ◽

Intracerebral Hemorrhage ◽

Multivariable Analysis ◽

Operation Time ◽

Icp Monitoring ◽

Robot Assisted ◽

Hematoma Evacuation ◽

Significant Difference ◽

Monitoring Group ◽

Hypertensive Intracerebral Hemorrhage

Objective: This study aimed to investigate the clinical efficacy of robot-assisted neuroendoscopic hematoma evacuation combined intracranial pressure (ICP) monitoring for the treatment of hypertensive intracerebral hemorrhage (HICH).Patients and Methods: A retrospective analysis of 53 patients with HICH undergoing neuroendoscopic hematoma evacuation in our department from January 2016 to December 2020 was performed. We divided the patients into two groups: the neuroendoscopic group (n = 32) and the robot-assisted neuroendoscopic combined ICP monitoring group (n = 21). Data on clinical characteristics, treatment effects, and outcomes were retrospectively reviewed and analyzed between these two groups.Results: The operation time of the procedure of the neuroendoscopic group was significantly longer than that of the robot-assisted neuroendoscopic combined ICP-monitoring group (mean time 153.8 ± 16.8 vs. 132.8 ± 15.7 min, P < 0.001). The intraoperative blood loss was significantly less in the robot-assisted neuroendoscopic combined ICP-monitoring group than in the neuroendoscopic group (215.4 ± 28.3 vs. 190.1 ± 25.6 ml, P = 0.001). However, the patients undergoing neuroendoscopic had a comparable hematoma clearance rate with those undergoing robot-assisted neuroendoscopic combined ICP monitoring (85.2 ± 4.8 vs. 89.2 ± 5.4%, P = 0.997). The complications rate was greater in the endoscopic group (25%) than in the robot-assisted neuroendoscopic combined ICP-monitoring group (9.5%) but without significant difference (P = 0.159). We also found that the dose of used mannitol was significantly less in the ICP monitoring group (615.2 ± 63.8 vs. 547.8 ± 65.3 ml, P < 0.001) and there was a significant difference in modified Rankin scale (mRS) score at discharge, patients with less mRS score in the robot-assisted neuroendoscopic combined ICP monitoring group than in the neuroendoscopic group (3.0 ± 1.0 vs. 3.8 ± 0.8, p = 0.011). Patients undergoing robot-assisted neuroendoscopic combined ICP monitoring had better 6-month functional outcomes, and there was a significant difference between the two groups (p = 0.004). Besides, multivariable analysis shows younger age, no complication, and robot-assisted neuroendoscopic combined ICP monitoring were predictors of 6-month favorable outcomes for the patients with HICH.Conclusion: Robot-assisted neuroendoscopic hematoma evacuation combined with ICP monitoring appears to be safer and more effective as compared to the neuroendoscopic hematoma evacuation in the treatment of HICH. Robot-assisted neuroendoscopic hematoma evacuation combined with ICP monitoring might improve the clinical effect and treatment outcomes of the patients with HICH.

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