The crisis of the third day in intracranial pressure dynamics following traumatic brain injury, fact or fiction?
Introduction: In 1960, Lazorthes and Campman introduced the concept of a ‘crisis of the third day’, which gained prominence in the field of traumatic brain injury (TBI), where it relates to neurological deterioration on the third day after injury. However, evidence regarding this phenomenon remains...
Saved in:
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-01-01
|
| Series: | Brain and Spine |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772529424013912 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850118482236014592 |
|---|---|
| author | R.D. Singh M.W.H. Bolscher J.T.J.M. van Dijck R.J.G. Vreeburg I.A.M. van Erp V. Lubrano G.C.W. de Ruiter B. Depreitere S.C. Cannegieter B. Siegerink T.A. van Essen W.C. Peul |
| author_facet | R.D. Singh M.W.H. Bolscher J.T.J.M. van Dijck R.J.G. Vreeburg I.A.M. van Erp V. Lubrano G.C.W. de Ruiter B. Depreitere S.C. Cannegieter B. Siegerink T.A. van Essen W.C. Peul |
| author_sort | R.D. Singh |
| collection | DOAJ |
| description | Introduction: In 1960, Lazorthes and Campman introduced the concept of a ‘crisis of the third day’, which gained prominence in the field of traumatic brain injury (TBI), where it relates to neurological deterioration on the third day after injury. However, evidence regarding this phenomenon remains scarce. Research question: This study aimed to analyze posttraumatic intracranial pressure (ICP) patterns in a large European cohort to investigate the existence of a third-day crisis and its impact on 12-month functional outcomes. Materials and methods: Data were analyzed from the prospective Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. Patients with TBI admitted to ICUs in 65 European centers who received ICP monitoring were included. ICP measurements, averaged per day, were analyzed using mixed models. The association between ICP peak timing and functional outcome was examined with multivariable logistic regression. Results: The study included 886 patients. Average ICP trajectories showed no significant changes over the first seven days post-injury, without elevation around the third day. Among 563 patients with ICP >20 during the first week, 45% reached their highest ICP after the third day. Elevated ICP (>20 mmHg) during the first week was associated with unfavorable 12-month outcomes, but the timing of ICP peak was not linked to functional outcomes. Discussion and conclusion: This multicenter study challenges the ‘crisis of the third day’ concept. No distinct ICP or TIL elevations were observed around the third day. Elevated ICP remains a prognostic indicator, but ICP peak timing does not correlate with functional outcomes. |
| format | Article |
| id | doaj-art-667fca9a265f4d88bb20f1557e9af809 |
| institution | OA Journals |
| issn | 2772-5294 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brain and Spine |
| spelling | doaj-art-667fca9a265f4d88bb20f1557e9af8092025-08-20T02:35:51ZengElsevierBrain and Spine2772-52942024-01-01410413510.1016/j.bas.2024.104135The crisis of the third day in intracranial pressure dynamics following traumatic brain injury, fact or fiction?R.D. Singh0M.W.H. Bolscher1J.T.J.M. van Dijck2R.J.G. Vreeburg3I.A.M. van Erp4V. Lubrano5G.C.W. de Ruiter6B. Depreitere7S.C. Cannegieter8B. Siegerink9T.A. van Essen10W.C. Peul11Department of Neurosurgery, University Neurosurgical Centre Holland (UNCH), Leiden University Medical Centre, Haaglanden Medical Center and Haga Teaching Hospital, Leiden, The Hague, the Netherlands; Corresponding author.Department of Neurosurgery, University Neurosurgical Centre Holland (UNCH), Leiden University Medical Centre, Haaglanden Medical Center and Haga Teaching Hospital, Leiden, The Hague, the NetherlandsDepartment of Neurosurgery, University Neurosurgical Centre Holland (UNCH), Leiden University Medical Centre, Haaglanden Medical Center and Haga Teaching Hospital, Leiden, The Hague, the NetherlandsDepartment of Neurosurgery, University Neurosurgical Centre Holland (UNCH), Leiden University Medical Centre, Haaglanden Medical Center and Haga Teaching Hospital, Leiden, The Hague, the NetherlandsDepartment of Neurosurgery, University Neurosurgical Centre Holland (UNCH), Leiden University Medical Centre, Haaglanden Medical Center and Haga Teaching Hospital, Leiden, The Hague, the NetherlandsService de Neurochirurgie, Hôpital de Rangueil, CHU de Toulouse, 1, Avenue Du Professeur-Jean-Poulhès, Toulouse, FranceDepartment of Neurosurgery, University Neurosurgical Centre Holland (UNCH), Leiden University Medical Centre, Haaglanden Medical Center and Haga Teaching Hospital, Leiden, The Hague, the NetherlandsNeurosurgery, University Hospitals Leuven, Leuven, BelgiumDepartment of Clinical Epidemiology, Leiden University Medical Center, Leiden, the NetherlandsDepartment of Clinical Epidemiology, Leiden University Medical Center, Leiden, the NetherlandsDepartment of Neurosurgery, University Neurosurgical Centre Holland (UNCH), Leiden University Medical Centre, Haaglanden Medical Center and Haga Teaching Hospital, Leiden, The Hague, the Netherlands; Department of Surgery, Division of Neurosurgery, QEll Health Sciences Centre and Dalhousie University, Halifax, Nova Scotia, CanadaDepartment of Neurosurgery, University Neurosurgical Centre Holland (UNCH), Leiden University Medical Centre, Haaglanden Medical Center and Haga Teaching Hospital, Leiden, The Hague, the NetherlandsIntroduction: In 1960, Lazorthes and Campman introduced the concept of a ‘crisis of the third day’, which gained prominence in the field of traumatic brain injury (TBI), where it relates to neurological deterioration on the third day after injury. However, evidence regarding this phenomenon remains scarce. Research question: This study aimed to analyze posttraumatic intracranial pressure (ICP) patterns in a large European cohort to investigate the existence of a third-day crisis and its impact on 12-month functional outcomes. Materials and methods: Data were analyzed from the prospective Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. Patients with TBI admitted to ICUs in 65 European centers who received ICP monitoring were included. ICP measurements, averaged per day, were analyzed using mixed models. The association between ICP peak timing and functional outcome was examined with multivariable logistic regression. Results: The study included 886 patients. Average ICP trajectories showed no significant changes over the first seven days post-injury, without elevation around the third day. Among 563 patients with ICP >20 during the first week, 45% reached their highest ICP after the third day. Elevated ICP (>20 mmHg) during the first week was associated with unfavorable 12-month outcomes, but the timing of ICP peak was not linked to functional outcomes. Discussion and conclusion: This multicenter study challenges the ‘crisis of the third day’ concept. No distinct ICP or TIL elevations were observed around the third day. Elevated ICP remains a prognostic indicator, but ICP peak timing does not correlate with functional outcomes.http://www.sciencedirect.com/science/article/pii/S2772529424013912Traumatic brain injuryIntracranial pressureTherapy intensity levelNeurosurgery |
| spellingShingle | R.D. Singh M.W.H. Bolscher J.T.J.M. van Dijck R.J.G. Vreeburg I.A.M. van Erp V. Lubrano G.C.W. de Ruiter B. Depreitere S.C. Cannegieter B. Siegerink T.A. van Essen W.C. Peul The crisis of the third day in intracranial pressure dynamics following traumatic brain injury, fact or fiction? Brain and Spine Traumatic brain injury Intracranial pressure Therapy intensity level Neurosurgery |
| title | The crisis of the third day in intracranial pressure dynamics following traumatic brain injury, fact or fiction? |
| title_full | The crisis of the third day in intracranial pressure dynamics following traumatic brain injury, fact or fiction? |
| title_fullStr | The crisis of the third day in intracranial pressure dynamics following traumatic brain injury, fact or fiction? |
| title_full_unstemmed | The crisis of the third day in intracranial pressure dynamics following traumatic brain injury, fact or fiction? |
| title_short | The crisis of the third day in intracranial pressure dynamics following traumatic brain injury, fact or fiction? |
| title_sort | crisis of the third day in intracranial pressure dynamics following traumatic brain injury fact or fiction |
| topic | Traumatic brain injury Intracranial pressure Therapy intensity level Neurosurgery |
| url | http://www.sciencedirect.com/science/article/pii/S2772529424013912 |
| work_keys_str_mv | AT rdsingh thecrisisofthethirddayinintracranialpressuredynamicsfollowingtraumaticbraininjuryfactorfiction AT mwhbolscher thecrisisofthethirddayinintracranialpressuredynamicsfollowingtraumaticbraininjuryfactorfiction AT jtjmvandijck thecrisisofthethirddayinintracranialpressuredynamicsfollowingtraumaticbraininjuryfactorfiction AT rjgvreeburg thecrisisofthethirddayinintracranialpressuredynamicsfollowingtraumaticbraininjuryfactorfiction AT iamvanerp thecrisisofthethirddayinintracranialpressuredynamicsfollowingtraumaticbraininjuryfactorfiction AT vlubrano thecrisisofthethirddayinintracranialpressuredynamicsfollowingtraumaticbraininjuryfactorfiction AT gcwderuiter thecrisisofthethirddayinintracranialpressuredynamicsfollowingtraumaticbraininjuryfactorfiction AT bdepreitere thecrisisofthethirddayinintracranialpressuredynamicsfollowingtraumaticbraininjuryfactorfiction AT sccannegieter thecrisisofthethirddayinintracranialpressuredynamicsfollowingtraumaticbraininjuryfactorfiction AT bsiegerink thecrisisofthethirddayinintracranialpressuredynamicsfollowingtraumaticbraininjuryfactorfiction AT tavanessen thecrisisofthethirddayinintracranialpressuredynamicsfollowingtraumaticbraininjuryfactorfiction AT wcpeul thecrisisofthethirddayinintracranialpressuredynamicsfollowingtraumaticbraininjuryfactorfiction AT rdsingh crisisofthethirddayinintracranialpressuredynamicsfollowingtraumaticbraininjuryfactorfiction AT mwhbolscher crisisofthethirddayinintracranialpressuredynamicsfollowingtraumaticbraininjuryfactorfiction AT jtjmvandijck crisisofthethirddayinintracranialpressuredynamicsfollowingtraumaticbraininjuryfactorfiction AT rjgvreeburg crisisofthethirddayinintracranialpressuredynamicsfollowingtraumaticbraininjuryfactorfiction AT iamvanerp crisisofthethirddayinintracranialpressuredynamicsfollowingtraumaticbraininjuryfactorfiction AT vlubrano crisisofthethirddayinintracranialpressuredynamicsfollowingtraumaticbraininjuryfactorfiction AT gcwderuiter crisisofthethirddayinintracranialpressuredynamicsfollowingtraumaticbraininjuryfactorfiction AT bdepreitere crisisofthethirddayinintracranialpressuredynamicsfollowingtraumaticbraininjuryfactorfiction AT sccannegieter crisisofthethirddayinintracranialpressuredynamicsfollowingtraumaticbraininjuryfactorfiction AT bsiegerink crisisofthethirddayinintracranialpressuredynamicsfollowingtraumaticbraininjuryfactorfiction AT tavanessen crisisofthethirddayinintracranialpressuredynamicsfollowingtraumaticbraininjuryfactorfiction AT wcpeul crisisofthethirddayinintracranialpressuredynamicsfollowingtraumaticbraininjuryfactorfiction |