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Related Concept Videos

Increased Intracranial Pressure l: Introduction01:14

Increased Intracranial Pressure l: Introduction

Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...
Increased Intracranial Pressure ll: Pathophysiology01:29

Increased Intracranial Pressure ll: Pathophysiology

Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins with...
Cerebral Edema ll: Pathophysiology01:22

Cerebral Edema ll: Pathophysiology

Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...
Traumatic Brain Injury l: Introduction01:28

Traumatic Brain Injury l: Introduction

DefinitionTraumatic brain injury, or TBI, is a disturbance of normal brain function induced by an external mechanical force, such as a direct blow to the head or a penetrating injury. It can affect both brain structure and function, producing a wide range of clinical outcomes. TBI is a heterogeneous condition, meaning its effects may differ based on the type, location, and severity of the injury.Basis of ClassificationTBI is classified based on severity, injury mechanism, or pathophysiology. In...
Cerebral Edema l: Introduction01:19

Cerebral Edema l: Introduction

Cerebral edema is a pathological increase in brain water content that disrupts intracranial pressure regulation and impairs neurological function. Because the cranial vault is rigid, even modest increases in tissue volume can compromise cerebral perfusion, distort neural structures, and initiate secondary injury. Cerebral edema develops through four principal mechanisms: vasogenic, cytotoxic, interstitial, and ionic.Vasogenic EdemaVasogenic edema arises from disruption of the blood–brain...

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A Bedside, Single Burr Hole Approach to Multimodality Monitoring in Severe Brain Injury
06:18

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Published on: March 26, 2019

Association Between Intracranial Pressure Variability and Clinical Outcomes in Acute Brain Injury: A Systematic

Vitaliy Voznyy1, Mouad Elganga1, Abramo A Rizk2

  • 1Temerty Faculty of Medicine, University of Toronto, Toronto.

Journal of Neurosurgical Anesthesiology
|June 15, 2026
PubMed
Summary

Higher short-term intracranial pressure variability (ICPV) in acute brain injury (ABI) patients predicts better outcomes. Long-term ICPV did not show a significant association with clinical outcomes in this meta-analysis.

Keywords:
acute brain injuriesclinical outcome assessmentintracranial pressure monitoringmeta-analysisvariability

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A Bedside, Single Burr Hole Approach to Multimodality Monitoring in Severe Brain Injury
06:18

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A Detailed Protocol for Physiological Parameters Acquisition and Analysis in Neurosurgical Critical Patients
05:01

A Detailed Protocol for Physiological Parameters Acquisition and Analysis in Neurosurgical Critical Patients

Published on: October 17, 2017

Area of Science:

  • Neuroscience
  • Critical Care Medicine
  • Medical Statistics

Background:

  • Acute brain injury (ABI) is a leading cause of mortality and disability.
  • Intracranial pressure (ICP) monitoring traditionally uses static thresholds, but ICP variability (ICPV) may offer prognostic value.
  • Understanding ICPV's role is crucial for improving neurocritical care outcomes.

Purpose of the Study:

  • To evaluate the association between short-term and long-term ICPV and clinical outcomes in adult patients with ABI.
  • To synthesize evidence from existing studies on ICPV and patient prognosis.
  • To identify potential prognostic markers in neurocritical care.

Main Methods:

  • Systematic literature search of Embase, Web of Science, Medline, Scopus, CENTRAL, and PubMed up to August 29, 2025.
  • Inclusion of prospective and retrospective studies on adult ABI patients with ICPV and outcome data.
  • Random-effects meta-analyses for short-term and long-term ICPV, with risk of bias assessment using ROBINS-E.

Main Results:

  • Ten studies involving 3243 ABI patients were included.
  • Higher short-term ICPV was significantly associated with reduced odds of poor clinical outcome (adjusted OR=0.58).
  • Long-term ICPV showed no statistically significant association with poor clinical outcome (adjusted OR=1.29).

Conclusions:

  • Short-term ICPV is associated with favorable clinical outcomes in patients with acute brain injury.
  • Long-term ICPV does not appear to have a significant prognostic role.
  • Further research with standardized ICPV metrics is needed to clarify its prognostic utility in neurocritical care.