Intracranial Pressure During Mobilization in a Patient With Postoperative Putaminal Hemorrhage: A Case Report

Rehabilitation and mobilization for patients with severe stroke, including postsurgical cases, are considered feasible if the intracranial pressure (ICP) remains below 20 mmHg. However, to the best of our knowledge, no study has evaluated real-time ICP changes during mobilization in patients with postoperative putaminal hemorrhage. In this case report, we detail the ICP fluctuations observed during mobilization in a patient with postoperative putaminal hemorrhage. A 47-year-old man was diagnosed with left putaminal hemorrhage and underwent emergency craniotomy for hematoma evacuation (day 1). Postoperatively, the patient was managed using continuous ICP monitoring. Mobilization (sitting on the edge of the bed) began on day 3, during which time the ICP was evaluated. The preintervention ICP was well controlled, ranging from 13 to 15 mmHg. During the transition to the sitting position, the patient attempted to rise on his own, leading to a transient ICP elevation exceeding 20 mmHg for approximately 20 seconds. While maintaining the sitting position, the ICP stabilized at approximately 5 mmHg without sustained elevation. The blood pressure, heart rate, and other vital signs remained stable throughout the intervention period. Our findings suggest that mobilization to a sitting position may be feasible without inducing sustained ICP elevation when ICP is well controlled.