ArticleJournal of Korean Neurosurgical Society2021
Changes in Blood Pressure and Heart Rate during Decompressive Craniectomy.
Article in Journal of Korean Neurosurgical Society, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 9 citations in OpenAlex.
- Posterior scalp block with bupivacaine and dexmedetomidine for pain management in posterior fossa surgeries: a prospective, double blind randomized controlled trial.Pain management · 2025Trial
- Neuromonitoring in the Decompressed Brain: Rethinking Physiology, Monitoring, and Thresholds After Decompressive Craniectomy.Neurocritical care · 2026Article
- Scoping Review on True and Relative Bradycardia in Trauma: How to Approach Bradycardia in Traumatic Brain Injury.Journal of cardiovascular translational research · 2026Review
- An Overview of Adult Acute Traumatic Neurologic Injury for the Anesthesiologist:Current anesthesiology reports · 2025Article
- Posterior communicating artery vasospasm impairs cerebral pulsatility in an experimental subarachnoid hemorrhage model.Frontiers in neurology · 2025Article
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
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Abstract
objectiveRapid increase in intracranial pressure (ICP) can result in hypertension, bradycardia and apnea, referred to as the Cushing phenomenon. During decompressive craniectomy (DC), rapid ICP decreases can cause changes in mean atrial blood pressure (mABP) and heart rate (HR), which may be an indicator of intact autoregulation and vasomotor reflex.
methodsA total of 82 patients who underwent DC due to traumatic brain injury (42 cases), hypertensive intracerebral hematoma (19 cases), or major infarction (21 cases) were included in this prospective study. Simultaneous ICP, mABP, and HR changes were monitored in one minute intervals during, prior to and 5-10 minutes following the DC.
resultsAfter DC, the ICP decreased from 38.1±16.3 mmHg to 9.5±14.2 mmHg (p<0.001) and the mABP decreased from 86.4±14.5 mmHg to 72.5±11.4 mmHg (p<0.001). Conversly, overall HR was no significantly changed in HR, which was 100.1±19.7 rate/min prior to DC and 99.7±18.2 rate/min (p=0.848) after DC. Notably when the HR increased after DC, it correlated with a favorable outcome (p<0.001), however mortality was increased (p=0.032) when the HR decreased or remained unchanged.
conclusionIn this study, ICP was decreased in all patients after DC. Changes in HR were an indicator of preserved autoregulation and vasomotor reflex. The clinical outcome was improved in patients with increased HR after DC.
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