Abstract:

Objective To explore the application value of intracranial-pressure (ICP) monitoring for ruptured intracranial aneurysm clipping operations. Methods A total of 57 patients with ruptured intracranial aneurysm underwent the clipping operation with ICP monitoring (basic or venticular catheter kit) implanted. The post-operative drug treatment and cerebral-spinal fluid (CSF) drainage were based on the ICP monitoring. The prognosis and complications of patients were analyzed.  Results The post-operative ICP of 42 patients was constantly below 20 mmHg (1 mmHg=0.133 kPa). Thirteen patients underwent mannitol treatment and CSF drainage according to the results of ICP monitoring and their ICPs maintained below 20 mmHg. One patient with intra-cerebral haematoma underwent a second operation and the symptoms were relieved. One patient with serious infarction died. Patients were followed up for 3-6 months after operation. CT examinations showed that there were 11 patients (19.3％) with different degrees of hydrocephalus. The incidence of hydrocephalus of patients who implanted the venticular catheter kit was 15.22%, which was significantly lower than that (36.36%) of patients who implanted the basic catheter kit (P<0.05). Conclusion ICP monitoring, especially the venticular catheter kit, can monitor the post-operative condition of ruptured intracranial aneurysm clipping operation, guide the treatment, and reduce complications.

Key words: intracranial-pressure monitoring, aneurysm clipping, hydrocephalus