Superior Outcomes With Ommaya Reservoir in Sustained Intracranial Hypertension Control

Persistent intracranial hypertension (ICH) is a difficulty that must frequently be faced in the neuro- intensive care unit (ICU). The management of ICH is quite varied, and the choice of measures is determined by the experience of attending doctors. We aimed to evaluate the efficacy of different intervention measures in treating non-traumatic persistent ICH.

A total of 119 non-traumatic intracranial hypertension cases treated in the neuro-ICU of the PLA General Hospital between 2010 and 2023 were retrospectively reviewed. Patients were divided into five groups according to the methods for controlling intracranial pressure (ICP). Based on the records of ICP, biochemical indicators, general status, and prognosis of patients in each group, the differences between groups and the differences within groups before and after intervention were compared. Repeated measures data of multiple groups were analyzed using generalized estimating equation (GEE) methods.

External ventricular drain (EVD), lumbar drainage (LD) and Ommaya reservoir (OR) had advantages in reducing ICP compared with the drug therapy alone (DT) group. Among them, the Ommaya reservoir exhibited optimal efficacy. Intervention with repeated lumbar puncture (LP) and the Ommaya reservoir effectively improved the general state of patients, evidenced by decreased mRS scores. The median creatinine value in the OR group decreased significantly at three months, suggesting that this method can moderate the renal burden. The OR group had the lowest probability of electrolyte imbalances and renal function damage, while the LD and EVD groups had a higher probability of pulmonary infection.

The Ommaya reservoir is an effective and safe means of controlling ICP and thus has great potential in treating non-traumatic persistent ICH.