Intracranial Pressure and Cerebral Perfusion Pressure in Large Spontaneous Intracranial Hemorrhage and Impact of Minimally Invasive Surgery

Autor: Mais N. Al-Kawaz, Yunke Li, Richard E. Thompson, Radhika Avadhani, Adam de Havenon, Joshua Gruber, Issam Awad, Daniel F. Hanley, Wendy Ziai
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Zdroj: Frontiers in Neurology, Vol 12 (2021)
Druh dokumentu: article
ISSN: 1664-2295
DOI: 10.3389/fneur.2021.729831
Popis: Introduction: We investigated the effect of hematoma volume reduction with minimally invasive surgery (MIS) on intracranial pressure (ICP) and cerebral perfusion pressure (CPP) in patients with large spontaneous intracerebral hemorrhage (ICH).Methods:Post-hoc analysis of the Minimally Invasive Surgery Plus Alteplase for Intracerebral Hemorrhage Evacuation (MISTIE III) study, a clinical trial with blinded outcome assessments. The primary outcome was the proportion of ICP readings ≥20 and 30 mmHg, and CPP readings 3) and mortality at 30 and 365 days. We assessed the relationship between proportion of high ICP and low CPP events and MIS using binomial generalized linear models, and outcomes using multiple logistic regression.Results: Of 499 patients enrolled in MISTIE III, 72 patients had guideline based ICP monitors placed, 34 in the MIS group and 38 in control (no surgery) group. Threshold ICP and CPP events ≥20/
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