Abstract
Cerebral perfusion pressure management through intraventricular intracranial pressure monitoring in spontaneous intracerebral hemorrhage: A case report
Highlights
Management of blood pressure (BP) in patients with spontaneous intracerebral hemorrhage (ICH) concern that significantly elevated BP may precipitate ongoing bleeding, and lowering BP might decrease cerebral perfusion and create secondary ischemia
Despite its various criteria for intracranial pressure (ICP) monitoring, the guidelines from American Heart Association (AHA)/American Stroke Association (ASA) recommend ICP monitoring in patients with Glasgow Outcome Scale (GCS) score < 9 associated with mass effect from intracranial hematoma, the clinical manifestation of trans-tentorial herniation, and significant intraventricular hemorrhage (IVH) or hydrocephalus.[5]
Postoperative Computed Tomography (CT) scan shows the removal of ICH, the tip of intraventricular ICP monitoring in the right lateral ventricle, and adequate bone decompression (Figure 2)
Summary
Blood pressure (BP) management in spontaneous intracerebral hemorrhage (ICH) is essential since increasing BP might involve ongoing bleeding. A 58-year-old woman came to the emergency room with a sudden decrease of consciousness for 4 hours before admission She had a history of uncontrolled hypertension for the last seven months and a previous stroke attack seven months ago. Postoperative CT scan shows the removal of ICH, the tip of intraventricular ICP monitoring in the right lateral ventricle, and adequate bone decompression (Figure 2). Manual ICP monitoring in this patient was set up from the external ventricular drainage (EVD) apparatus connected to the infusion line set for measuring the ICP (Figure 3) From this modification device, we can continuously drainage the cerebrospinal fluid (CSF) based on the EVD set up point as well as measuring the ICP.
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