Barnett G H, Ropper A H, Romeo J
Department of Neurosurgery, Massachusetts General Hospital, Boston.
J Neurosurg. 1988 Apr;68(4):585-8. doi: 10.3171/jns.1988.68.4.0585.
The relationship between intracranial pressure (ICP) and outcome was studied in 10 adults with encephalitis. Eight had biopsy-proven herpes simplex encephalitis, one had acute hemorrhagic leukoencephalitis, and in one case the cause of encephalitis was unknown. Monitoring of ICP was instituted because of clinical deterioration or computerized tomography evidence of brain swelling, and was begun a mean of 7 days after the onset of symptoms and continued for a mean of 9 days. All five survivors, but only one of the five fatalities, had an initial ICP of less than 12 mm Hg (p less than 0.05). Four patients with a mean daily ICP of less than 20 mm Hg survived, whereas five of six patients with higher ICP's died (p less than 0.05). Peak ICP did not occur until the 12th day of illness on average. The Glasgow Coma Scale score at the time the ICP monitor was inserted did not correlate with outcome. Intracranial pressure monitoring in severe encephalitis may be a useful adjunct for therapy and an indicator of prognosis.
对10例成人脑炎患者的颅内压（ICP）与预后的关系进行了研究。其中8例经活检证实为单纯疱疹病毒性脑炎，1例为急性出血性白质脑炎，1例脑炎病因不明。因临床病情恶化或计算机断层扫描显示脑肿胀而进行ICP监测，监测在症状出现后平均7天开始，持续平均9天。所有5名幸存者，但5名死亡者中只有1名，初始ICP低于12 mmHg（p<0.05）。平均每日ICP低于20 mmHg的4例患者存活，而ICP较高的6例患者中有5例死亡（p<0.05）。平均直到发病第12天才出现ICP峰值。插入ICP监测器时的格拉斯哥昏迷量表评分与预后无关。在严重脑炎中进行颅内压监测可能是一种有用的治疗辅助手段和预后指标。
