Abstract
Introduction: Recent research has been equivocal regarding the usefulness of intracranial pressure (ICP) monitoring for traumatic intracerebral haemorrhage (ICH). We aimed to investigate attitudes of clinicians from as wide an international audience as possible. Materials and Methods: A SurveyMonkey® questionnaire was distributed to individuals, including members of the Society of British Neurological Surgeons, the European Brain Injury Consortium, the Euroacademia Multidisciplinaria Neurotraumatologica and the neurotrauma committee of the World Federation of Neurosurgical Societies. Results: Ninety-eight participants from at least 25 different countries completed the survey (86 surgeons). ICP was routinely monitored by 76 % and would be monitored by 5 % more if they had equipment. ICP monitoring was valued (0 = not at all important, 10 = critically important) as 10 by 21 % (median = 8; Q1 = 7, Q3 = 9). Responders were aware of 16 trials that investigated the value of ICP monitoring in neurotrauma, including BEST TRIP (n = 35), Rescue ICP (n = 13) and DECRA (n = 8). Other results are discussed. Discussion: Despite equivocation in the literature, we found that ICP monitoring continues to be routinely performed and is highly valued. Interestingly, only 36 % of responders were aware of the BEST TRIP trial, which found no difference in outcome between patients with a head injury managed with or without ICP monitoring.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Badri S, Chen J, Barber J, Temkin NR, Dikmen SS, Chesnut RM, Deem S, Yanez ND, Treggiari MM (2012) Mortality and long-term functional outcome associated with intracranial pressure after traumatic brain injury. Intensive Care Med 38:1800–1809
Barmparas G, Singer M, Ley E, Chung R, Malinoski D, Margulies D, Salim A, Bukur M (2012) Decreased intracranial pressure monitor use at level II trauma centers is associated with increased mortality. Am Surg 78:1166–1171
Bratton SL, Chestnut RM, Ghajar J, McConnell Hammond FF, Harris OA, Hartl R, Manley GT, Nemecek A, Newell DW, Rosenthal G, Schouten J, Shutter L, Timmons SD, Ullman JS, Videtta W, Wilberger JE, Wright DW (2007) Guidelines for the management of severe traumatic brain injury. IX. Cerebral perfusion thresholds. J Neurotrauma 24(Suppl 1):S59–S64
Bratton SL, Chestnut RM, Ghajar J, McConnell Hammond FF, Harris OA, Hartl R, Manley GT, Nemecek A, Newell DW, Rosenthal G, Schouten J, Shutter L, Timmons SD, Ullman JS, Videtta W, Wilberger JE, Wright DW (2007) Guidelines for the management of severe traumatic brain injury. VIII. Intracranial pressure thresholds. J Neurotrauma 24(Suppl 1):S55–S58
Chesnut RM, Temkin N, Carney N, Dikmen S, Rondina C, Videtta W, Petroni G, Lujan S, Pridgeon J, Barber J, Machamer J, Chaddock K, Celix JM, Cherner M, Hendrix T (2012) A trial of intracranial-pressure monitoring in traumatic brain injury. N Engl J Med 367:2471–2481
Francis R, Gregson BA, Mendelow AD (2014) Attitudes to intracranial pressure monitoring of traumatic intracerebral haemorrhage. Br J Neurosurg 28:663–665. doi:10.3109/02688697.2014.881463
Mendelow AD, Gregson BA, Rowan EN, Francis R, McColl E, McNamee P, Chambers IR, Unterberg A, Boyers D, Mitchell P, and on behalf of the STITCH(Trauma) Investigators (2015) Early Surgery versus Initial Conservative Treatment in Patients with Traumatic Intracerebral Hemorrhage (STITCH[Trauma]): The First Randomized Trial. J Neurotrauma. 32(17):1312–1323
Rubiano AM, Puyana JC (2013) Intracranial pressure monitoring in traumatic brain injury. N Engl J Med 368(18):1748–1751
Conflicts of Interest
Richard Francis and Barbara Gregson have no conflicting interests to declare. David Mendelow is a director of Newcastle Neurosurgical Foundation and a consultant for Stryker.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Francis, R., Gregson, B.A., Mendelow, A.D. (2016). Attitudes in 2013 to Monitoring Intracranial Pressure for Traumatic Intracerebral Haemorrhage. In: Ang, BT. (eds) Intracranial Pressure and Brain Monitoring XV. Acta Neurochirurgica Supplement, vol 122. Springer, Cham. https://doi.org/10.1007/978-3-319-22533-3_3
Download citation
DOI: https://doi.org/10.1007/978-3-319-22533-3_3
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-22532-6
Online ISBN: 978-3-319-22533-3
eBook Packages: MedicineMedicine (R0)