| Objective Traumatic brain injuries,with its high lethality,disability and high treatment cost,is a serious threat to people’s life and property safety,and remains a difficult and important concern for neurosurgeons at present.As the most common clinical syndrome in neurosurgical patients with traumatic brain injuries,increased intracranial pressure seriously affects the patient’s treatment outcome and prognosis.Intracranial pressure monitoring has become a standard technique for the treatment of high intracranial pressure caused by traumatic brain injuries,especially in the treatment of severe traumatic brain injuries（s TBI）,and effective detection of intracranial pressure has become is an important prerequisite for the treatment of traumatic brain injuries.This study aims to compare the consistency of invasive intracranial pressure monitoring in the parenchymal type of brain with non-invasive intracranial pressure monitoring by FVEP in the postoperative treatment of patients with severe traumatic brain injuries.The value of invasive and non-invasive intracranial pressure monitoring in the postoperative treatment of patients with severe traumatic brain injuries was also investigated by comparing with CT imaging performance.Methods Twenty-seven patients with severe traumatic brain injuries（GCS score 3-8）who were admitted to our neurosurgery department from April 2016 to December 2021 for craniotomy to remove hematoma and decompression treatment were selected for the study,and were divided into invasive and non-invasive groups according to their intracranial pressure monitoring methods,and into death and non-death groups according to their different prognosis,and the intracranial pressure monitoring values were recorded on postoperative days 1-5,respectively.The postoperative intracranial pressure monitoring values on days 1-5 were recorded,and the postoperative cranial CT images on days 1,3 and 5 were scored.The intracranial pressure measurements and their trends in both modalities on postoperative days 1-5 in both groups were analyzed,as well as the comparison of ICP values with cranial CT scoring in both groups.Results 1.ICP was lower in the non-invasive intracranial pressure monitoring group on the postoperative day compared with the preoperative day,and the difference was statistically significant（p<0.05）,suggesting a significant effect of surgical decompression.2.In the non-death group,the mean ICP in the invasive intracranial pressure monitoring group was higher than that in the non-invasive intracranial pressure monitoring group on the 2nd and 3rd postoperative days,and the difference was statistically significant（p<0.05）,while the difference in ICP in the remaining days was not statistically significant（p>0.05）;in the death group,the difference in ICP between the two groups on the 1st-5th postoperative days was not statistically significant（p>0.05）.3.The overall intracranial pressure values of patients in the death group were higher than those in the non-death group on postoperative days 2-4,and the difference was statistically significant（p value < 0.05）.4.There was a correlation between the intracranial pressure measurements and cranial CT scores of both non-invasive and invasive modalities in non-dead patients,and there was a positive correlation,with the correlation coefficients of r=0.88 and r=0.90 in the non-invasive and invasive groups,respectively（p<0.05）.5.There was no statistically significant difference between the invasive and non-invasive groups in general information such as age,gender,and GCS score at admission（p>0.05）;there was no statistically significant difference in the poor prognosis rate（χ2=0.617,p=0.432）and the incision rate of canalization（χ2=0.008,p=0.930）（p>0.05）.Conclusion Both parenchymal invasive intracranial pressure monitoring and FVEP noninvasive intracranial pressure monitoring can safely and effectively indicate the postoperative intracranial pressure values and their trends in patients with severe traumatic brain injuries.Both parenchymal invasive intracranial pressure monitoring and FVEP noninvasive intracranial pressure monitoring were positively correlated with cranial CT imaging performance in severe traumatic brain injuries,and their intracranial pressure values were correlated with CT scores,and the correlation coefficients were r=0.90/r=0.88,respectively（p<0.05）.Combining cranial CT with intracranial pressure monitoring provides an important reference in the selection of treatment plans and prognostic assessment of patients with traumatic brain injuries.For the selection of postoperative intracranial pressure monitoring modalities in patients with severe traumatic brain injuries,multimodal and multifunctional invasive intracranial pressure monitoring is more recommended.the applicability and operability of FVEP noninvasive intracranial pressure monitor in the treatment of severe traumatic brain injuries needs to be further optimized. |
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