Monitoring noninvasive intracranial pressure and cerebral perfusion pressure in treatment of patients with hypertensive intracerebral hemorrhage

Objective To evaluate clinical significance of monitoring noninvasive intracranial pressure (NICP) and cerebral perfusion pressure (CPP) in treatment of patients with hypertensive intracerebral hemorrhage. Methods This clinical randomized controlled trial enrolled 120 patients with hypertensive intracerebral hemorrhage who had sought medical treatment in our department from June 2008 through May 2010. They were randomized equally into a monitoring group where NICP and CPP were continuously monitored before and after operation and a non-monitoring group where no monitoring of NICP and CPP was performed. Results In the monitoring group,increased NICP and decreased CPP were shown in 50 patients and only 10 patients were shown with normal NICP (＜26.6mmHg) and CPP (＞ 124.3 mm Hg). The abnormal NICP and CPP continuously monitored were treated with specific interventions like further operation or medication. In the non-monitoring group,patients received only conventional treatments.According to the Glasgow Outcome Scale (GOS), 31 patients (51.7％) had good recovery,20 (33.3％) were moderately disabled,5 (8.3％) severely disabled and 4 (6.7％) dead in the monitoring group while 23 (38.3％) patients had good recovery,18 (30.0％)were moderately disabled,10 (16.7％) severely disabled and 9 (15.0％) dead in the non-monitoring group.The outcomes of the monitoring group were significantly better than those of the non-monitoring group (P＜0.05). Conclusion Continuous monitoring of NICP and CPP before and after operation should be performed in the treatment of patients with hypertensive intracerebral hemorrhage because it is helpful for clinical medication and reducing complications and mortality as well. Key words: Hypertension intracerebral hematoma; Noninvasive intracranial pressure; Cerebral perfusion pressure; Monitoring