Character and clinical significance of postoperative intracranial hypertention

Intracranial pressure monitoring was applied to 60 severe patients following craniocerebral surgery and to observe the character of postopertive intracranial pressure（ICP）and.its clinical significance.High ICP was found in 46（76.7%）of 60 cases.In these 46 patients,ICP increased within 2 hours after operation in 7,with postoperative intracranial hematoma in 4 and pneumocephalus in 1.ICP rose at about 12 hours and fell within 48—72 hours after operation in 37 case CT scan was performed on 10 of them and cerebral edema was found in 8 cases.ICP waves were normal in 40 cases,36 of them had good recovery or moderate disability.On the contrary,4 of 6 cases with abnormal ICP waves died and one became vegetative.ICP was lower than 40 mmHg in 41 cases and 37 of them had good recovery or moderate disability.ICP was higher than 40 mmHg in 5 cases.4 of them were died and 1 was vegetative.In the discussion,it is emphasized that postoperative high ICP usually lacks of closed relationship with clinical features; the causes of high ICP can be preliminarily estimated by its character;and if ICP exceeds 40 mmHg or persists for more than 72 hours or companied by abnormal ICP waves the outcome is poor.