The Value of Intracranial Pressure (ICP) Measurement in Acute Severe Head Injury Showing Diffuse Cerebral Swelling

Role of intracranial pressure values and patterns in predicting outcome in traumatic brain injury: a systematic review

“…Two studies differentiated between patients with intracranial mass lesions or diffuse brain injury [18,19]. Five studies described ICP variations over time and categorized the values as ''normal ICP'' (<20 mmHg), elevated (>20 mmHg) but reducible ICP'', and ''not reducible ICP'' [12,13,18,20,22]. One of them dichotomized the values as ''normal ICP'', and ''elevated ICP'' with subsequent stratification in ''high then normal'', ''normal then high'' and ''elevated throughout'' [13].…”

“…A total of 721 patients were included in the five studies evaluating the association between ICP patterns and outcome [12,13,18,20,22]. In the original articles, ICP patterns were classified as normal, raised but reducible, and refractory ICPs.…”

“…Excluded patients were those with gunshots wounds to the head or those who already fulfilled the criteria of brain death. Four studies investigated the association of stratified ICP values with outcome, and provided sufficient data for a quantitative analysis [18][19][20][21]. Two studies differentiated between patients with intracranial mass lesions or diffuse brain injury [18,19].…”

“…No study reported the GOS at hospital discharge or beyond 12 months. As some of the studies collapsed the five GOS score into three distinctive categories [18,20], data are summarized to reflect the same classification for all reports included, even when the complete scale was reported [19,21].…”

“…A total of 409 patients were included in four studies evaluating the association between ICP values and outcome (Table 3) [18][19][20][21]. The GOS was only available between 3 and 13 months.…”