Abstract
Introduction: Secondary brain injury due to increased intracranial pressure (ICP) contributes to post-traumatic morbidity and mortality. Although it is often taught that increased ICP begins early after traumatic brain injury, some patients develop increased ICP after the first 3 days post-injury. We examined our data to describe temporal patterns of increased ICP. Methods: This is a retrospective review of prospectively collected physiologic and demographic data. Results: Seventy-seven patients were included. We identified four patterns of increased ICP: beginning within 72 h (early), beginning after 72 h (late), early increases with resolution, and then a second rise after 72 h (bimodal), and continuously increased ICP. Late increases in ICP occur in 17% of this cohort. Peak day of swelling was day 7 for the "late" rise group and day 4 for the other patients with increased ICP. Forty-four percent of patients showed enlargement of cerebral contusions on follow-up imaging at 24 h post-injury. Conclusions: Late rises in ICP were not rare in this cohort. This is clinically relevant as it may impact decisions about ICP monitor removal. Differences between groups in age, CT patterns of injury, fluid therapy, osmotic use, and fever were not statistically significant.
| Original language | English |
|---|---|
| Pages (from-to) | 280-286 |
| Number of pages | 7 |
| Journal | Neurocritical Care |
| Volume | 10 |
| Issue number | 3 |
| DOIs | |
| State | Published - Jun 1 2009 |
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Keywords
- Intracranial hypertension
- Intracranial pressure
- Traumatic brain injury
ASJC Scopus subject areas
- Clinical Neurology
- Critical Care and Intensive Care Medicine
Cite this
Patterns of increased intracranial pressure after severe traumatic brain injury. / O'Phelan, Kristine H; Park, Dalnam; Efird, Jimmy T.; Johnson, Katherine; Albano, Melanie; Beniga, Juliet; Green, Deborah M.; Chang, Cherylee W J.
In: Neurocritical Care, Vol. 10, No. 3, 01.06.2009, p. 280-286.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Patterns of increased intracranial pressure after severe traumatic brain injury
AU - O'Phelan, Kristine H
AU - Park, Dalnam
AU - Efird, Jimmy T.
AU - Johnson, Katherine
AU - Albano, Melanie
AU - Beniga, Juliet
AU - Green, Deborah M.
AU - Chang, Cherylee W J
PY - 2009/6/1
Y1 - 2009/6/1
N2 - Introduction: Secondary brain injury due to increased intracranial pressure (ICP) contributes to post-traumatic morbidity and mortality. Although it is often taught that increased ICP begins early after traumatic brain injury, some patients develop increased ICP after the first 3 days post-injury. We examined our data to describe temporal patterns of increased ICP. Methods: This is a retrospective review of prospectively collected physiologic and demographic data. Results: Seventy-seven patients were included. We identified four patterns of increased ICP: beginning within 72 h (early), beginning after 72 h (late), early increases with resolution, and then a second rise after 72 h (bimodal), and continuously increased ICP. Late increases in ICP occur in 17% of this cohort. Peak day of swelling was day 7 for the "late" rise group and day 4 for the other patients with increased ICP. Forty-four percent of patients showed enlargement of cerebral contusions on follow-up imaging at 24 h post-injury. Conclusions: Late rises in ICP were not rare in this cohort. This is clinically relevant as it may impact decisions about ICP monitor removal. Differences between groups in age, CT patterns of injury, fluid therapy, osmotic use, and fever were not statistically significant.
AB - Introduction: Secondary brain injury due to increased intracranial pressure (ICP) contributes to post-traumatic morbidity and mortality. Although it is often taught that increased ICP begins early after traumatic brain injury, some patients develop increased ICP after the first 3 days post-injury. We examined our data to describe temporal patterns of increased ICP. Methods: This is a retrospective review of prospectively collected physiologic and demographic data. Results: Seventy-seven patients were included. We identified four patterns of increased ICP: beginning within 72 h (early), beginning after 72 h (late), early increases with resolution, and then a second rise after 72 h (bimodal), and continuously increased ICP. Late increases in ICP occur in 17% of this cohort. Peak day of swelling was day 7 for the "late" rise group and day 4 for the other patients with increased ICP. Forty-four percent of patients showed enlargement of cerebral contusions on follow-up imaging at 24 h post-injury. Conclusions: Late rises in ICP were not rare in this cohort. This is clinically relevant as it may impact decisions about ICP monitor removal. Differences between groups in age, CT patterns of injury, fluid therapy, osmotic use, and fever were not statistically significant.
KW - Intracranial hypertension
KW - Intracranial pressure
KW - Traumatic brain injury
UR - http://www.scopus.com/inward/record.url?scp=70349256136&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=70349256136&partnerID=8YFLogxK
U2 - 10.1007/s12028-008-9183-7
DO - 10.1007/s12028-008-9183-7
M3 - Article
C2 - 19165634
AN - SCOPUS:70349256136
VL - 10
SP - 280
EP - 286
JO - Neurocritical Care
JF - Neurocritical Care
SN - 1541-6933
IS - 3
ER -