MỘT SỐ YẾU TỐ LIÊN QUAN ĐẾN ÁP LỰC NỘI SỌ Ở NGƯỜI BỆNH CHẤN THƯƠNG SỌ NÃO NẶNG

Abstract

This study examined factors associated with intracranial pressure (ICP) in patients with severe traumatic brain injury (TBI). A cross-sectional analysis was conducted on 45 patients at the Neurosurgery Centre of Viet Duc Friendship Hospital. The majority of patients were male (93.0%) with a mean age of 36.36 ± 17.77 years, and traffic accidents were the leading cause of injury (86.7%). Intracranial pressure was significantly associated with the pupillary reflex, as patients with bilaterally dilated and unreactive pupils exhibited elevated ICP (p = 0.045). Additionally, ICP was linked to age, Glasgow Coma Scale (GCS) score, midline shift, and mean arterial blood pressure (MAP). A one-point decrease in the preoperative GCS score increased ICP by 2.759 mmHg, while each 1 mm increase in midline shift raised ICP by 1.222 mmHg. Similarly, every 1 mmHg rise in MAP correlated with a 0.411 mmHg increase in ICP. The combination of four key factors – bilaterally dilated pupils with absent reflexes, a declining GCS score, increasing midline shift, and rising MAP – indicates that intracranial pressure has escalated to a threshold necessitating surgical intervention.