title: Changes in intracranial pressure gradients between the cerebral hemispheres in patients with intracerebral hematomas in one cerebral hemisphere.
abstract: BACKGROUND
  Intracranial-pressure (ICP) monitoring is useful for patients with increased ICP following hemorrhagic stroke. In this study, the changes in pressure gradients between the two cerebral hemispheres were investigated after hemorrhagic stroke of one side, and after a craniotomy.
  
  
  METHODS
  Twenty-four patients with acute cerebral hemorrhages and intracerebral hematomas who exhibited mass effect and midline shift to the contralateral side on computed tomography were selected for this study. After admission, both sides of the cranium were drilled, and optical fiber sensors were implanted to monitor the brain parenchyma pressure (BPP) in both cerebral hemispheres. All patients underwent surgical hematoma evacuations. The preoperative and postoperative BPP data from both cerebral hemispheres were collected at various time points and compared pairwise.
  
  
  RESULTS
  There were statistically significant differences (P < 0.01) in the preoperative BPP values between the two hemispheres at three different time points. Differences in the BPP values between the two hemispheres at the time of surgery, and 24 and 48 h after surgery, were not statistically significant (P > 0.05). The posteroperative BPPs of both hemispheres were statistically significantly lower than preoperative recordings.
  
  
  CONCLUSIONS
  BPP sensors should be applied to the injured cerebral hemisphere, because this becomes the source of increased ICP. Hematoma evacuation surgery effectively decreases ICP and eliminates pressure gradients between the two cerebral hemispheres, consequently enabling brain shift correction.
authors.affiliation: Department of Neurosurgery, Hangzhou Second Hospital, College of Medicine, Hangzhou Normal University, 126 Wenzhou Road, Hangzhou, 310015 China.
authors.forename: Wusi
authors.initials: W
authors.lastname: Qiu
authors.affiliation: Department of Neurosurgery, Hangzhou Second Hospital, College of Medicine, Hangzhou Normal University, 126 Wenzhou Road, Hangzhou, 310015 China.
authors.forename: Qizhou
authors.initials: Q
authors.lastname: Jiang
authors.affiliation: Department of Neurosurgery, Hangzhou Second Hospital, College of Medicine, Hangzhou Normal University, 126 Wenzhou Road, Hangzhou, 310015 China.
authors.forename: Guoming
authors.initials: G
authors.lastname: Xiao
authors.affiliation: Department of Neurosurgery, Hangzhou Second Hospital, College of Medicine, Hangzhou Normal University, 126 Wenzhou Road, Hangzhou, 310015 China.
authors.forename: Weiming
authors.initials: W
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Second Affiliated Hospital, College of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou, 310009 China.
authors.forename: Hong
authors.initials: H
authors.lastname: Shen
mesh_terms: D000328:Adult; D000368:Aged; D002543:Cerebral Hemorrhage / Q000473:pathology* / Q000601:surgery; D003399:Craniotomy / Q000379:methods; D005260:Female; D006406:Hematoma / Q000473:pathology* / Q000601:surgery; D006801:Humans; D019586:Intracranial Hypertension / Q000175:diagnosis* / Q000473:pathology; D007427:Intracranial Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D011446:Prospective Studies; D020521:Stroke / Q000473:pathology* / Q000601:surgery; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Cerebral hemisphere; Elevated intracranial pressure; Intracranial pressure monitoring; Intracranial-pressure monitoring