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Updated: Apr 30, 2026
Minimally Invasive Endoscopic Intracerebral Hemorrhage Evacuation
Published on: October 15, 2021
Association of Intracranial Pressure Monitoring on Postoperative Outcomes in Spontaneous Intracerebral Hemorrhage: A
Yunfeng He1, Henglin Chen1, Shu Zhong1
1Department of Neurosurgery, Affiliated Jianhu Hospital of Xinglin College, Nantong University, Nantong, China.
Insights
Intracranial pressure (ICP) monitoring in patients with spontaneous intracerebral hemorrhage (ICH) undergoing surgery improved functional outcomes and reduced hospital stays. This monitoring did not increase mortality or complications, suggesting its potential role in postoperative care.
Area of Science:
- Neurosurgery
- Neurology
- Critical Care Medicine
Background:
- Spontaneous intracerebral hemorrhage (ICH) poses significant management challenges.
- Optimizing postoperative outcomes in ICH patients is crucial for recovery.
- The role of intracranial pressure (ICP) monitoring in surgical ICH management requires clarification.
Purpose of the Study:
- To evaluate the association between ICP monitoring and postoperative outcomes in patients with spontaneous ICH.
- To determine the impact of ICP monitoring on functional status, mortality, and other safety parameters.
Main Methods:
- Systematic review and meta-analysis of observational studies.
- Literature search across major databases (Cochrane Library, Pubmed, Embase, Web of Science).
- Primary outcomes: unfavorable functional outcome and mortality; Secondary outcomes: hospital stay, hematoma clearance, operative time, complications.
Main Results:
- ICP monitoring was linked to lower rates of unfavorable functional outcomes (OR = 0.27) and shorter hospital stays (MD = -3.90 days).
- No significant differences were found in mortality (OR = 1.24), hematoma clearance, operative time, or complication rates.
- Subgroup analysis showed benefits in hypertensive ICH patients undergoing minimally invasive surgery.
Conclusions:
- ICP monitoring is associated with improved functional outcomes in surgically treated spontaneous ICH patients.
- No increase in mortality or complications was observed with ICP monitoring.
- Further prospective studies are needed to validate the role of ICP monitoring in postoperative ICH management.
Introduction:
This study aimed to evaluate the potential association of intracranial pressure (ICP) monitoring on postoperative outcomes among patients with spontaneous intracerebral hemorrhage (ICH).
Methods:
This study conducted a systematic review and meta-analysis of relevant literature retrieved across the Cochrane Library, PubMed, Embase, and Web of Science from their inception to July 1, 2025. The primary efficacy outcome was unfavorable functional outcome (modified Rankin Scale 4-5 or Glasgow Outcome Scale 1-3). The primary safety outcome was mortality. Secondary outcomes included hospital stay, hematoma clearance rate, operative time, recurrent hemorrhage, and infection rates. Subgroup analyses were performed based on surgical intervention, hematoma type, and follow-up duration.
Results:
A total of 551 patients who underwent surgical treatment for spontaneous ICH were included in the analysis, based on five observational studies. Compared with the non-ICP group, patients who received ICP monitoring were associated with lower rates of unfavorable functional outcome (OR = 0.27, 95% CI: 0.15 to 0.46) and shorter hospital stays (MD = -3.90 days, 95% CI: -5.09 to -2.71). No significant differences were observed in mortality (OR = 1.24, 95% CI: 0.71 to 2.17), hematoma clearance rate, operative time, or complication rates. Subgroup analyses further indicated that, among patients with hypertensive ICH undergoing minimally invasive surgery, the use of adjunctive ICP monitoring was associated with a lower incidence of unfavorable functional outcome without a corresponding increase in mortality.
Conclusion:
The use of ICP monitoring was associated with improved functional outcomes in surgically treated patients with spontaneous ICH, without an observed increase in mortality or complications. These findings suggest a potential role of ICP monitoring in postoperative management, which warrants further validation in prospective studies.
