Original article                                                              

UDC: 616.714.1-001.5:616.12-008.331.1

doi:10.5633/amm.2011.0302

 

  

SEVERE BRAIN INJURIES: CORRELATION BETWEEN SURVIVAL AND INTRACRANIAL HYPERTENSION

 

Aleksandar Kostić¹, Ivan Stefanović¹, Vesna Novak¹, Aleksandar Igić¹, Boban Jelenković¹ and Goran Ivanov²

 

Clinic of Neurosurgery, Clinical Center Niš, Niš, Serbia¹

Center for Anestesiology, Clinical Center Niš, Niš, Serbia²

 

 

 

There are several reasons of intracranial pressure (ICP) increase in the brain trauma. Brain edema, due to the brain-blood bariere injury, contusion of brain tissue and intracranial hematomas that represent mass lesion, cerebrovascular autoregulation failure which leads to hemodinamic disorder, and traumatic subarchnoid haemorrhagae that is commonly associated with CSF flow disturbances are the main causes. The aim of our study was to examine the survival of patients with severe brain trauma in the presence of different values of ICP. This prospective study included 32 patients with intracranial pressure monitored, and appropriate treatment undertaken. Twenty-two patients (68.75%) had elevated ICP, and in 10 patients (31,25%) there were no criteria of intracranial hypertnesion (ICHTN). The results of our study showed that absolute lethal value of ICHTN is 50mmHg and over – none of the injured survived such ICP if lasted more than two hours, because of inevitable brain and brainstem ischemia and failure of the vital functions. The relatively lethal values of ICP ranged from 40 to 50mmHg, in the case of which we menaged to prevent a fatal outcome in one out of five cases.  Acta Medica Medianae 2011;50(3):10-15.

 

      Key words: traumatic brain injury, intracranial monitoring, intracranial hypertension