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Related Concept Videos

Holter Monitor: 24-Hour Monitoring01:23

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Holter monitoring is a continuous electrocardiography (ECG) recording that tracks the heart's electrical activity over an extended period, generally 24 to 48 hours. This noninvasive diagnostic tool detects irregular heart rhythms that may not be captured during a standard ECG performed in a clinical setting.DeviceThe Holter monitor is a portable, small device connected to several electrodes on the patient's chest. These electrodes detect the heart's electrical signals and transmit them to the...
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Related Experiment Video

Updated: May 3, 2026

Automated Midline Shift and Intracranial Pressure Estimation based on Brain CT Images
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Intracranial Pressure Monitor Insertion in Isolated Traumatic Brain Injury: Does Timing Matter?

Michael D Gaziano1, Peter Aziz2, Alison Muller1

  • 1Division of Trauma and Critical Care, Department of Surgery, Reading Hospital, Reading, PA, USA.

The American Surgeon
|August 1, 2025
PubMed
Summary
This summary is machine-generated.

For severe traumatic brain injury (sTBI), the timing of intracranial pressure monitoring (ICPM) insertion did not affect mortality rates. Expedient open cranial surgery appears more critical than early ICPM for reducing death risk in sTBI patients.

Keywords:
craniectomyintracranial pressure monitorsevere traumatic brain injury

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Area of Science:

  • Neurosurgery
  • Trauma Surgery
  • Critical Care Medicine

Background:

  • Intracranial pressure monitoring (ICPM) is recommended for severe traumatic brain injury (sTBI).
  • Optimal timing for ICPM insertion after sTBI remains understudied.
  • This study investigates the impact of ICPM insertion timing on patient outcomes.

Purpose of the Study:

  • To evaluate the association between the timing of ICPM insertion and mortality in patients with isolated blunt sTBI.
  • To compare outcomes based on different ICPM insertion time windows: no ICPM, ≤4 hours, >4 to ≤12 hours, and >12 hours.

Main Methods:

  • Utilized data from the American College of Surgeons Trauma Quality Improvement Program (2018-2021).
  • Included patients ≥16 years with isolated blunt sTBI, excluding those with non-survivable brain injury or requiring emergent open cranial procedures within 2 hours.
  • Employed binary logistic regression to analyze variables associated with mortality.

Main Results:

  • 17,715 patients were analyzed; 14% received ICPM, 15% underwent open cranial surgery, and 49% died.
  • ICPM insertion timing (≤4h, >4-≤12h, >12h) was not significantly associated with reduced mortality compared to no ICPM.
  • Open cranial procedures were associated with a significantly reduced risk of death (OR 0.40 [0.36-0.45]).

Conclusions:

  • For isolated blunt sTBI, the timing of ICPM insertion does not appear to influence mortality.
  • Expeditious open cranial procedures may be more crucial for reducing mortality than early ICPM insertion in sTBI.