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Clinical observation of the time course of raised intracranial pressure after subarachnoid hemorrhage

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Abstract

The time course of intracranial pressure (ICP) after subarachnoid hemorrhage (SAH) is not well known. This retrospective study was conducted to investigate the occurrence and the dynamic variation of raised ICP post-SAH. ICP was prospectively studied in 120 patients with SAH who were admitted to neurocritical care within 24 h of hemorrhage. Patients underwent continuous ICP monitoring for at least 7 days, unless they died. Clinical status on admission, radiographic tests, treatment details and neurological outcome on discharge were analyzed in relation to ICP. The highest daily mean ICP and the day when ICP reduced to normal levels were assessed. Of the 120 patients studied, 112 (93.3 %) encountered ICP elevation whilst in hospital. The daily mean ICP was higher in Hunt and Hess grades IV–V patients than grades I–III patients (P = 0.01). The elevated ICP remained at a higher level for the initial 3 days (grades I–III patients) or 4 days (grades IV–V patients), after which the pressure decreased towards normal levels. The in-patient mortality was significantly increased in the high ICP variability group (P = 0.001), which was divided by the cutoff point using receiver operating characteristic curve analysis. Raised ICP mainly occurs within 8 days post-SAH, especially the initial 3–4 days. Those highlight the need for earlier management of ICP after SAH.

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Acknowledgments

This work was supported by grants from National Natural Science Fund (No. 811014 73) and the Fund of Chinese Education Department (No. 20115503120008).

Conflict of interest

The Authors declare that there is no conflict of interest.

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Authors and Affiliations

  1. Department of Neurology, Chongqing Banan Hospital, Chongqing, 401320, China

    Yuhua Lv

  2. Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, 1st You Yi Road, Yu Zhong District, Chongqing, 400016, China

    Dayan Wang & Ge Tan

  3. Department of Neurosurgery, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200127, China

    Jin Lei

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  1. Yuhua Lv
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  2. Dayan Wang
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  3. Jin Lei
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  4. Ge Tan
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Correspondence to Ge Tan.

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Lv, Y., Wang, D., Lei, J. et al. Clinical observation of the time course of raised intracranial pressure after subarachnoid hemorrhage. Neurol Sci 36, 1203–1210 (2015). https://doi.org/10.1007/s10072-015-2073-9

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  • DOI: https://doi.org/10.1007/s10072-015-2073-9

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