The Clinical Research On Noninvasive Monitoring Of Intracranial Pressure Using Flash Visual Evoked Potential And Brain CT

Objective We study the relationship between noninvasive monitoring of intracranialpressure（ICP）using flash visual evoked potential (FVEP) and head CT, to evaluate theusefulness of baseline FVEP testing in patients of increased intracranial pressure afterhead trauma,and in order to provid a reliable evidence for the clinical diagnosis andtreatment. Methods32head injury patients with conventional treatment（GCS3～15score）and18head injury patients with operation treatment（GCS3～12score）weremonitored using FVEP on day1、3、5、7、10、14，then all cases had been examinedby head CT in time.Analysis of the change of the intracranial pressure and Head CTscore in craniocerebral injury with conventional treatment and operationtreatment.Variance Analysis of the the intracranial pressure and Head CT score in thesame types of cases on day1、3、5、7、10、14, Analysis of the intracranial pressure andHead CT score in the different types of cases(minor grade、moderate grade、severe grade)on the same day.Correlation Analysis of the intracranial pressure and Head CT score onmoderate grade and severe grade craniocerebral injury with conventional treatment andoperation treatment. Analysis the relationship between the third ventricle、lateralventricle、basilar cistern、midline and intracranial pressure.50patients were recordedby FVEP for three times in15minutes,compared the difference of4measurement inlatency of N2wave in the same pation for the same time. Results There was nosignificant difference in the intracranial pressure and Head CT score on the minor gradecraniocerebral injury（P>0.05）. The intracranial pressure and Head CT score on thethird and fifth day was higher compared with other days in the moderate grade andsevere grade craniocerebral injury（P <0.05）.The intracranial pressure and Head CT score on the severe grade craniocerebral injury was higher compared with the moderatecases,and the moderate cases was higher compared with the minor cases（P <0.05）.There was a positive correlation between the intracranial pressure and Head CT scoreon moderate grade and severe grade craniocerebral injury with conventional treatmentand operation treatment,(r=0.92, r=0.96). Either compression or obliteration of the thirdventricle and the basilar cistern，compression of lateral ventricle the midline shift moreobvious result in rise of ICP.The peak latency was the least error from the fourlatencys.(F=6.21，P<0.05). Conclusion FVEP can exact and safely monitor theintracranial pressure,and it can be used to guide treatment and to judge prognosis ofpatients with craniocerebral injury.