Intraventricular pressure monitoring in patients with thalamic and ganglionic hemorrhages

Arquivos de Neuro-Psiquiatria

Clement Hamani¹  Marcus Vinicius Zanetti¹  Fernando Campos Gomes Pinto¹  Almir Ferreira Andrade¹  Orildo Ciquini Jr¹  Raul Marino Jr¹ 

[1] ,University of São Paulo Hospital das Clínicas Division of NeurosurgerySão Paulo SP ,Brazil

关键词: intracranial pressure;    thalamic and ganglionic hemorrhage;    intraventricular catheters;    cerebral hematomas;    stroke;    hypertension;    pressão intracraniana;    hemorragias talâmicas e de gânglios da base;    catéteres intraventriculares;    AVCH;    hematomas cerebrais;    hipertensão;   

DOI  :  10.1590/S0004-282X2003000300010

来源: SciELO

【 摘 要 】

In the present study, we have evaluated the use of intraventricular pressure catheters in thalamic and ganglionic hemorrhages. Ten patients admitted in our Emergency Department in Glasgow Coma Scale (GCS) equal or below 13 enrolled the study (at least one point should have been lost in the eye opening score to exclude purely aphasic patients that were fully alert). After a complete clinical and neurological evaluation, computed tomography scans were obtained and the volume of the hematomas, as well as presence or absence of hydrocephalus, were considered. Intraventricular pressure catheters connected in parallel to external derivation systems were implanted and patients were thereafter sent to the ICU. Patients that presented mass effect lesions with sustained increased ICP levels or clinical and neurological deterioration were submitted in addition, to the surgical evacuation of the hematomas. Clinical evolution, complications and the rehabilitation of the patients were recorded. Clinical outcome was assessed with the Glasgow Outcome Score. In all but three patients the initial intracranial pressure levels were bellow 20 mmHg (mean for all patients was 14.1 ± 6.5 mmHg). Notwithstanding, these three patients were extremely difficult to treat. For this group of patients mortality was 100%. Among the patients that presented ICP levels bellow 20 mmHg, 04 developed hydrocephalus and 03 did not display ventricular dilation. As expected, the major benefits concerning the intraventricular pressure catheters connected in parallel with external derivation systems were observed in the group of patients that presented ICP levels bellow 20 mmHg and had hydrocephalus. Mild non-statistically significant correlations for all the three groups were achieved either when the initial GCS and ICP levels (r=-0.28, p=0.43) or when ICP levels and the volumes of the hematomas were compared (r=0.38, p=0.28). In addition, no significant correlations were observed concerning the final outcome of the patients and the variables previously evaluated.

【 授权许可】

CC BY   
 All the contents of this journal, except where otherwise noted, is licensed under a Creative Commons Attribution License