Efficacy of Postoperative Intracranial Pressure Monitoring after Brain Tumor Surgery in Elderly

, Shin Heon Lee1; , Ki Su Park1; , Taek Kyun Nam1; , Yong Sook Park1; , Seung Won Park1; , Jeong Taik Kwon1; , Young Baeg Kim1; , Kyung Tae Kim2

Clinical Article

Journal of Korean Society of Geriatric Neurosurgery 2016;12(2):185-190.
Published online September 30, 2016.

Efficacy of Postoperative Intracranial Pressure Monitoring after Brain Tumor Surgery in Elderly

Shin Heon Lee1 , Ki Su Park1 , Taek Kyun Nam1 , Yong Sook Park1 , Seung Won Park1 , Jeong Taik Kwon1 , Young Baeg Kim1 , Kyung Tae Kim2

¹Department of Neurosurgery, Chung-Ang University College of Medicine, Seoul, ²Department of Neurosurgery, Kyungpook National University School of Medicine, Daegu, Korea

노인 뇌종양 환자에서 수술 후 두개내압 모니터링의 효용성

이신헌¹·박기수¹·남택균¹·박용숙¹·박승원¹·권정택¹·김영백¹·김경태²

중앙대학교 의과대학 신경외과학교실¹, 경북대학교 의과대학 신경외과학교실²

Abstract

Objective
To investigate the efficacy of postoperative intracranial pressure (ICP) monitoring after brain tumor surgery in the elderly.
Methods
Between January 2010 and December 2015, 103 patients underwent ICP monitoring after brain tumor surgery. Among them, 28 consecutive patients aged >65 years, who underwent elective brain surgery, were retrospectively reviewed. The patients were divided into an increased ICP group (n=11) and a stable ICP group (n=17), and the postoperative status of the two groups were compared.
Results
Among the 28 patients, 11 (39.3%) had ICP elevation. All patients who presented increased ICP underwent immediate CT scan and postoperative hemorrhages were observed. The patients were treated with mannitol infusion for reducing the ICP. In contrast, 17 patients (60.7%) had stable ICP, among which 8 (47.1%) had postoperative hemorrhage. The hospitalization period of the increased ICP group was significantly greater than that of the stable ICP group (43.4 days versus 26.1 days; p<0.05). Amount of postoperative subdural hemorrhage of the increased ICP group was significantly greater than that of the stable ICP group (5.9 cc versus 0 cc; p<0.05). In addition, postoperative epidural hemorrhage of the increased ICP group was significantly greater than that of the stable ICP group (6.4 cc versus 0.9 cc; p<0.05).
Conclusion
ICP monitoring may be advantageous in immediate postoperative management of the elderly after elective brain tumor surgery.

Key Words: Intracranial pressure, Brain tumor, Postoperative, Hemorrhage