Ziai – ICP, CCP in ICH and IVH | Maryland CC Project

Dr. Wendy Ziai delivers a presentation on intracranial pressure (ICP) and cerebral perfusion in spontaneous intracerebral hemorrhage (ICH), discussing the physiological basis of ICP monitoring, relevant guidelines, and clinical trial data, including the BEST TRIP trial, ERIC study, CLEAR-3, and MISTI 3 trials. She addresses the challenges in determining optimal ICP thresholds and the limitations of current measurement techniques, and also explores the potential of ICP trajectory modeling. The presentation concludes that while excursions from brain trauma foundation thresholds appear harmful, especially in early mortality and functional outcomes, the relevance of TBI targets to ICH management remains undetermined, followed by a question and answer session.

Outlines

Part 1: Introduction and Guidelines

Part 2: Studies and Data Analysis

Part 3: Limitations and Future

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Ziai – ICP, CCP in ICH and IVH

Maryland CC Project

Part 1: Introduction and Guidelines

Introduction to Intracranial Pressure and Cerebral Perfusion in Intracerebral Hemorrhage

ICP Monitoring in Intracerebral Hemorrhage: Guidelines and Evidence

Part 2: Studies and Data Analysis

Determinants of High ICP and the ERIC Study on ICP Monitoring in ICH

CLEAR-3 Trial Data: ICP, CPP, and Outcomes in Severe IVH

Threshold Analysis and MISTI 3 Trial Data: Surgical Intervention and ICP/CPP

Part 3: Limitations and Future

Limitations of Fixed Thresholds and Trajectory Modeling of ICP and CPP

Limitations of ICP and CPP Measurements and Conclusions

Q&A: Blood Pressure Management, EVD Placement, and Future Directions

Ziai – ICP, CCP in ICH and IVH

Maryland CC Project

Part 1: Introduction and Guidelines

00:01Introduction to Intracranial Pressure and Cerebral Perfusion in Intracerebral Hemorrhage

Introduction to Intracranial Pressure and Cerebral Perfusion in Intracerebral Hemorrhage

07:38ICP Monitoring in Intracerebral Hemorrhage: Guidelines and Evidence

ICP Monitoring in Intracerebral Hemorrhage: Guidelines and Evidence

Part 2: Studies and Data Analysis

14:03Determinants of High ICP and the ERIC Study on ICP Monitoring in ICH

Determinants of High ICP and the ERIC Study on ICP Monitoring in ICH

20:06CLEAR-3 Trial Data: ICP, CPP, and Outcomes in Severe IVH

CLEAR-3 Trial Data: ICP, CPP, and Outcomes in Severe IVH

26:00Threshold Analysis and MISTI 3 Trial Data: Surgical Intervention and ICP/CPP

Threshold Analysis and MISTI 3 Trial Data: Surgical Intervention and ICP/CPP

Part 3: Limitations and Future

32:33Limitations of Fixed Thresholds and Trajectory Modeling of ICP and CPP

Limitations of Fixed Thresholds and Trajectory Modeling of ICP and CPP

39:45Limitations of ICP and CPP Measurements and Conclusions

Limitations of ICP and CPP Measurements and Conclusions

45:14Q&A: Blood Pressure Management, EVD Placement, and Future Directions

Q&A: Blood Pressure Management, EVD Placement, and Future Directions