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Updated: Apr 19, 2026

A Bedside, Single Burr Hole Approach to Multimodality Monitoring in Severe Brain Injury
Published on: March 26, 2019
[Intracranial pressure targeted treatment in acute bacterial meningitis increased survival]
Martin Glimåker1, Bibi Johansson2, Halla Halldorsdottir3
1Enheten för infektionssjukdomar, medicinska kliniken Solna - Karolinska Institutet och Karolinska Universitetssjukhuset Solna, Stockholm, Sweden Enheten för infektionssjukdomar, medicinska kliniken Solna - Karolinska Institutet och Karolinska Universitetssjukhuset Solna, Stockholm, Sweden.
Abstract:
To evaluate the efficacy of intracranial pressure (ICP)-targeted treatment, compared to standard intensive care, in adults with community acquired acute bacterial meningitis (ABM) and severely impaired consciousness, a prospectively designed intervention-control comparison study was performed. Included were patients with confirmed ABM and severely impaired mental status on admission. Fifty-two patients, given ICP-targeted treatment at a neuro-intensive care unit, and 53 control cases, treated with conventional intensive care, were included. All patients received intensive care with me-chanical ventilation, sedation, antibiotics and corticosteroids according to current guidelines. ICP-targeted treatment was performed in the intervention group, aiming at ICP 50 mmHg. The mortality was significantly lower in the intervention group compared to controls, 5/52 (10%) versus 16/53 (30%). Furthermore, only 17 patients (32%) in the control group fully recovered, compared to 28 (54%) in the intervention group. Early neuro-intensive care using ICP-targeted therapy reduces mortality and improves the overall outcome in adult patients with ABM and severely impaired mental status on admission.
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