title: Relationship between intracranial pressure and aneurysmal subarachnoid hemorrhage grades.
abstract: OBJECTIVE
  Intracranial pressure (ICP) is frequently elevated following aneurysmal subarachnoid hemorrhage (aSAH). In this prospective study, the factors associated with increased ICP and the relationship between ICP and the aSAH grade were evaluated.
  
  
  METHODS
  Consecutive patients with prospective aSAH were enrolled within 24h after disease onset. Clinical scoring, including the Hunt and Hess scale, the WFNS scale and the Fisher scale, was performed upon admission. Consciousness was evaluated based on the Glasgow Coma Scale, and the subarachnoid hemorrhage volume was determined according to a CT scan. Then, an ICP monitor was placed, and ICP was recorded. The relationship between ICP and the aSAH grade was examined using Spearman correlation coefficients. Additionally, some clinical characteristics of the patients, including age, sex, location and size of the aneurysm, hydrocephalus and rebleeding, were recorded and analyzed.
  
  
  RESULTS
  A total of 165 patients were enrolled in this study. Of these patients, 111 (67.2%) displayed elevated ICP (≥ 20 mm Hg). The patients who underwent intubation or who experienced rebleeding or hydrocephalus displayed an elevated ICP compared with those who did not (P = 0.002, P = 0.001 and P = 0.008, respectively). There was a positive linear correlation between ICP and both the Hunt and Hess grade and the WFNS grade (correlation coefficients of 0.731 and 0.761, respectively). The correlation between ICP and the Fisher grade was weak according to the correlation coefficient of only 0.093.
  
  
  CONCLUSIONS
  ICP following aSAH positively correlates with the patient's consciousness, but no relationship was detected between ICP and the subarachnoid hemorrhage volume.
authors.affiliation: Department of Neurosurgery, West China Hospital of Sichuan University, China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Radiology, Sichuan Cancer Hospital, China.
authors.forename: Jin-xiu
authors.initials: JX
authors.lastname: Chen
authors.affiliation: Department of Neurosurgery, West China Hospital of Sichuan University, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Mao
authors.affiliation: Department of Neurosurgery, West China Hospital of Sichuan University, China.
authors.forename: Yan-hui
authors.initials: YH
authors.lastname: Liu
authors.affiliation: Department of Neurosurgery, West China Hospital of Sichuan University, China. Electronic address: wangxiangtim@gmail.com.
authors.forename: Chao
authors.initials: C
authors.lastname: You
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007427:Intracranial Pressure / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011859:Radiography; D012720:Severity of Illness Index; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology*
keywords: Aneurysmal subarachnoid hemorrhage; Fisher scale; Hunt and Hess scale; Intracranial hypertension; Intracranial pressure monitoring; WFNS grade