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The role of decompressive semicranial brain excision (DC) in malignant stroke (MCI) is well known, but little is known about changes in the course of intracranial pressure (ICP) in patients undergoing such surgery.
a recent study published in the authoritative journal Stroke on Cardiovascular Disease, in which researchers investigated the role of invasive ICP monitoring in post-DC MCI patients and hypothesed that postoperative ICP could predict patient mortality.
in this retrospective observational study of MCI patients who received DC, ICP was continuously recorded at hour intervals for the first 72 hours after DC.
average ICP is calculated on an hourly basis and combined with the ICP per patient.
researchers analyzed the working characteristics of subjects per hour for average ICP and subgroups by age (≥60 years old and 60 years old).
the study analyzed 111 patients, with a mortality rate of 29 percent for 60-year-olds and 41 percent ≥ for 60-year-olds.
10mmHg threshold in the first 72 hours after surgery is a reliable predictive indicator of death in MCI patients, with an acceptable sensitivity of 70% and specificity of up to 97%.
existing known death predictors cannot predict death.
this, there is a need to re-evaluate the postoperative ICP in MCI patients and to require that the ICP thresholds for these patients be redefined to determine further treatment.
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