Rebaud P, Berthier J C, Hartemann E, Floret D
Unités de Réanimation Pédiatrique, Hôpital Debrousse, Hôpital Edouard Herriot, Lyon, France.
Intensive Care Med. 1988;14(5):522-5. doi: 10.1007/BF00263524.
To determinate the importance of intracranial hypertension in central nervous system (CNS) acute infections, we studied intracranial pressure (ICP) in 27 patients, age 45 days to 13 years. Fourteen had meningitis and 13 had encephalitis; all were in deep coma with Glasgow Coma Scale 7 or less. Intracranial hypertension defined by a mean ICP above 15 mmHg, was observed in 12 patients with meningitis (86%) and in 9 with encephalitis (69%). Patients with meningitis exhibited a sudden and severe intracranial hypertension. A striking difference was noted between survivors and non survivors who had a very high maximal ICP with a severe reduction of cerebral perfusion pressure (CPP). Intracranial hypertension occurred in all patients with acute primary encephalitis but in only 3/7 patients with post-infectious encephalitis. ICP monitoring seems to be important in the comatose forms of: (1) bacterial meningitis in the early period (2) herpes encephalitis (3) post-infectious encephalitis with severe status epilepticus.
为确定颅内高压在中枢神经系统（CNS）急性感染中的重要性，我们研究了27例年龄在45天至13岁之间患者的颅内压（ICP）。其中14例患有脑膜炎，13例患有脑炎；所有患者均处于深度昏迷，格拉斯哥昏迷量表评分为7分或更低。平均ICP高于15 mmHg定义为颅内高压，在12例脑膜炎患者（86%）和9例脑炎患者（69%）中观察到。脑膜炎患者表现出突然且严重的颅内高压。在幸存者和非幸存者之间发现了一个显著差异，非幸存者的最大ICP非常高，脑灌注压（CPP）严重降低。所有急性原发性脑炎患者均出现颅内高压，但感染后脑炎患者中只有3/7出现。ICP监测似乎在以下昏迷形式中很重要：（1）早期细菌性脑膜炎；（2）疱疹性脑炎；（3）伴有严重癫痫持续状态的感染后脑炎。
