Department of Neurology, Division of Cerebrovascular Disease and Neurocritical Care, The Ohio State University, Columbus, Ohio; and.
Lyerly Neurosurgery, Baptist Neurological Institute, Jacksonville, Florida.
Neurosurg Focus. 2017 Nov;43(5):E7. doi: 10.3171/2017.8.FOCUS17419.
Intracranial pressure (ICP) monitoring has been widely accepted in the management of traumatic brain injury. However, its use in other pathologies that affect ICP has not been advocated as strongly, especially in CNS infections. Despite the most aggressive and novel antimicrobial therapies for meningitis, the mortality rate associated with this disease is far from satisfactory. Although intracranial hypertension and subsequent death have long been known to complicate meningitis, no specific guidelines targeting ICP monitoring are available. A review of the literature was performed to understand the pathophysiology of elevated ICP in meningitis, diagnostic challenges, and clinical outcomes in the use of ICP monitoring.
颅内压(ICP)监测在颅脑损伤的治疗中已得到广泛认可。然而,在其他影响 ICP 的疾病中,其应用并未得到如此强烈的推荐,尤其是在中枢神经系统感染中。尽管针对脑膜炎采用了最积极和最新型的抗菌治疗,但该疾病的死亡率仍远不理想。尽管颅内高压和随之而来的死亡一直以来都是脑膜炎的并发症,但目前尚无针对 ICP 监测的具体指南。本文对文献进行了回顾,以了解脑膜炎时 ICP 升高的病理生理学、诊断挑战以及 ICP 监测的临床结果。