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This article provides a comprehensive review and analysis of the significance of intracranial pressure (ICP) monitoring, including the discovery of pressure reactivity index, its measurement methods, advantages, and limitations, as well as the derived parameters of pressure reactivity index and its mechanism in affecting patient prognosis. The methods used to determine pressure reactivity index are classified into invasive and non-invasive approaches. The pressure reactivity index can aid in evaluating patient outcomes, calculating optimal brain perfusion values, and enhancing the tolerance of damaged brains. Furthermore, its derived parameters also perform well in assessing the prognosis of patients with head injury. This article details the progress of pressure reactivity index in head injury. [ABSTRACT FROM AUTHOR]

Objective To study the normal reference values of intracranial pressure and cerebral perfusion pressure in children of different ages. Methods A retrospective study was conducted on the children with simple epidural hematoma who received hematoma removal and implantation for intracranial pressure monitoring in our department from January 2015 to June 2022.The intracranial pressure and arterial blood pressure of the children were monitored per hour after surgery, and the changes in intracranial pressure and cerebral perfusion pressure were analyzed based on time and age in different age groups.The intracranial pressure and cerebral perfusion pressure in stable period (72 h after surgery) were used as the relative normal reference values, and the 95% range of intracranial pressure and cerebral perfusion pressure were calculated statistically by percentile method as the reference range. Results A total of 207 children were included in this study, including 25 in the < 2-year-old group, 82 in the 2~6-year-old group and 100 in the >6-year-old group.Intracranial pressure in different age groups was increased rapidly after a short period of low level, while cerebral perfusion pressure experienced a short period of high level, and both reached a peak and a trough from 12 to 24 h after surgery, and gradually reached a stable range at 72 h after surgery.The range of intracranial pressure 72 h after surgery was 3.0~8.0 mmHg for the < 2-year-old group, 5.0~11.0 mmHg for the 2~6-year-old group, and 6.0~14.0 mmHg for the >6-year-old group.Cerebral perfusion pressure range was 50.9~68.7, 55.0~73.3, and 57.3~79.6 mmHg, respectively for the above 3 age groups. Conclusion The normal ranges of intracranial pressure and cerebral perfusion pressure are different in children of different ages, and we suggest increasing with age.

Objective To analyze the clinical characteristics of changes in intracranial pressure (ICP) and cerebral perfusion pressure (CPP) and determine their intervention thresholds in children with severe traumatic brain injury (STBI). Methods This prospective observational study was conducted among the children with STBI admitted in the Children's Hospital of Chongqing Medical University between June, 2014 and June 2018. ICP and CPP of the children were dynamically monitored at every hour after the operation. The theoretical thresholds of ICP and CPP were adopted from literature, and the pressure-time indexes (PTIs) for these thresholds were calculated and their predictive ability was assessed using the receiver operating characteristic (ROC) curve. For children in different age groups (< 2 years, 2-7 years and >7 years), the area under the ROC curve (AUC) was calculated according to the PTIs for each theoretical threshold and Glasgow Outcome Scale score at 6 months after the trauma. The theoretical thresholds corresponding to the maximum AUC was determined to be the optimal thresholds. Results A total of 115 children with STBI were included in this study. For children aged < 2 years (25 cases), 2-7 years (52 cases) and >7 years (38 cases), the age-specific thresholds of ICP was 14.4, 20.0 and 21.6 mmHg, and those of CPP was 45.0, 55.0 and 55.0 mmHg respectively. Conclusion The intervention thresholds of ICP and CPP differ among the STBI chidren at different ages. In children with STBI aged < 2 years, 2-7 years and >7 years, we recommend postoperative ICP of 14.4, 20.0 and 21.6 mmHg, and CCP of 45.0, 55.0 and 55.0 mmHg respectively, as the thresholds for initiating interventions.

Objective: To explore the application effect of neuroelectrophysiology combined with intracranial pressure (ICP) and cerebral perfusion pressure (CPP) monitoring in intracranial aneurysm clipping. Methods: A total of 60 patients with intracranial aneurysm who underwent craniotomy in our hospital from December 2018 to January 2020 were selected and divided into two groups by a simple randomization method, with 30 cases in each group. The control group performed intracranial aneurysm clipping surgery, and the observation group was based on the control group with intraoperative neuroelectrophysiology, ICP, and CPP monitoring. Comparison of the aneurysm clipping between the two groups, the new neurological deficits on the first day after the operation, the Glasgow Coma Score (GCS) before the operation, 1 day after the operation, and 3 months after the operation, and the National Institutes of Health Stroke Scale ( NIHSS) score and good prognosis rate 3 months after operation. Results: Both groups of aneurysms were completely clipped. The rate of new neurological deficits in the observation group was 6.67% (2/30) on the first day after surgery, which was lower than 26.67% (8/30) in the control group (P<0.05); The GCS score of the observation group was higher than that of the control group on the 1st day, and the NIHSS score was lower than that of the control group (P<0.05); after excluding cases lost to follow-up, the excellent and good rates of GOS classification and mRS classification in the observation group were 88.89% and 88.89%, respectively. Compared with 88.00% and 84.00% of the control group, the difference was not statistically significant (P>0.05). Conclusion: The use of neuroelectrophysiology combined with ICP and CPP monitoring can grasp the blood flow of the brain tissue of patients undergoing intracranial aneurysm clipping in real time. According to the monitoring results, timely corresponding intervention measures can be taken to prevent irreversible cerebral ischemia changes and improve postoperative changes. Early patient's state of consciousness reduces the occurrence of early postoperative neurological deficits. [ABSTRACT FROM AUTHOR]

Objective To investigate the effect of intracranial pressure/cerebral perfusion pressure( ICP/CPP) guided treatment strategy in improving the long-term prognosis of patients with poor-grade ruptured intracranial aneurysms. Methods The clinical data of 48 patients with poorgrade ruptured intracranial aneurysms were analyzed retrospectively,23 of which underwent the ICP/CPP guided treatment and 25 cases underwent the conventional treatment. The prognosis at 90 days after the operation, the incidence of delayed cerebral infarction and complications, and mortality of the two groups were contrastively evaluated. Results Compared with the conventional treatment group, the ICP guided treatment group had lower incidence of delayed cerebral infarction and better prognosis in the 90 days follow-up. There was no significant difference in the mortality rate and the incidence of complications between the two groups( P > 0. 05). Conclusion Based on the support of comprehensive neuro intensive care, the ICP/CPP guided treatment strategy can significantly reduce the incidence of delayed cerebral infarction and improve the long-term prognosis of patients with poor-grade ruptured aneurysms, compared with the conventional treatment. [ABSTRACT FROM AUTHOR]

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