Janny P, Colnet G, Georget A M, Chazal J
Surg Neurol. 1978 Dec;10(6):371-5.
Intracranial pressure was recorded continuously during an average of 15 days in 17 patients suffering from primary intracerebral hemorrhage. In 12 cases the highest pressures were recorded just after the stroke; then the intracranial pressure decreased and became normal in an average of 20-30 days. Other patterns of evolution were less often observed: a rapid and lethal elevation of pressure in one case, a constantly low pressure in two, and a stagnant evolution with moderate hypertension in two others. Secondarily developing intracranial hypertension was never observed during the monitoring period. Evacuation of the clots was performed in six patients. This only slightly shortened the course of the increased intracranial pressure. It is concluded that intracerebral hematoma appears as an expanding lesion only during the time of its formation. The prognosis depends more upon the destructions by the hemorrhage than upon the increased pressure. Nevertheless, true hypertension is possible. Knowledge of intracranial pressure in the course of intracerebral hemorrhage is important in deciding whether the treatment is to be surgical or conservative. Measurements of the intracranial pressure in our practice has reduced the number of interventions, with identical or slightly improved results.
对17例原发性脑出血患者连续记录平均15天的颅内压。12例患者在中风后即刻记录到最高颅内压；随后颅内压下降，平均20 - 30天后恢复正常。其他演变模式较少见：1例压力迅速致命性升高，2例持续低颅内压，另2例颅内压呈停滞性演变伴中度高血压。监测期间未观察到继发性颅内高压。6例患者进行了血肿清除术。这仅略微缩短了颅内压升高的病程。得出的结论是，脑内血肿仅在其形成期间表现为不断扩大的病变。预后更多地取决于出血造成的破坏，而非颅内压升高。然而，真正的高血压是可能的。了解脑出血过程中的颅内压对于决定治疗是采用手术还是保守方法很重要。在我们的实践中，颅内压测量减少了干预次数，结果相同或略有改善。
