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1977年Becker等建议对重型颅脑损伤病人(Glasgow 计分≤8分者)应施行ICP监护,以确定是否采取外科手术,来防止继发性脑损伤并改善预后。为明确ICP监护指征,许多学者研究了CT异常与ICP增高之间的关系,包括占位效应、中线移位、对侧脑室扩大、第三脑室缩小及中脑环池消失等。 由于ICP监护有一定危险性,有学者提出对重型颅脑伤中一部份较少发生ICP增高者可不行ICP监护。Narayan报道脑损伤昏迷病人的CT若正常,ICP增高的可能性较低(<13％)。而Eisenberg认为,重型脑损伤病人最初CT无占位效应、
In 1977, Becker et al recommended that patients with severe craniocerebral injury (Glasgow score ≤ 8 points) should be monitored by ICP to determine whether to take surgery to prevent secondary brain injury and improve prognosis. To clarify the indications for ICP monitoring, many scholars studied the relationship between CT abnormalities and elevated ICP, including mass effect, midline shift, contralateral ventricle expansion, the third ventricle shrinkage and disappearance of the middle cerebral cortex. Because there is a certain degree of risk of ICP monitoring, some scholars have suggested that some patients with severe craniocerebral injury less ICP may not ICP monitoring. Narayan reports that if the CT of a brain injury coma is normal, ICP is less likely to be elevated (<13%). And Eisenberg believes that patients with severe brain injury initially CT no placeholder effect,