Effect of intracranial pressure monitoring-based therapy on clinical efficacy and serum levels in neurosurgical patients with severe intracerebral hemorrhage.

Objective: To investigate the effect of intracranial pressure (ICP) monitoring combined with hematoma evacuation on clinical efficacy and serum markers in neurosurgical patients with severe intracerebral hemorrhage. Methods: A total of 120 patients with severe intracerebral hemorrhage treated in the Department of Neurology, Taihe Hospital, Hubei University of Medicine from January 2025 to January 2026 were retrospectively enrolled. According to whether postoperative ICP monitoring was performed, the patients were divided into an ICP monitoring group (hematoma evacuation + external ventricular drain-based ICP monitoring) and a control group (hematoma evacuation alone). Propensity score matching at a 1:1 ratio was used to balance baseline characteristics, and 57 patients were ultimately included in each group. The surgical indicators, 3-month favorable outcome defined as Glasgow Outcome Scale score 4-5, neurological deficit scores, serum levels of endothelin-1 (ET-1), matrix metalloproteinase-9 (MMP-9), advanced oxidation protein products (AOPP), cortisol (Cor), and norepinephrine (NE), activity of daily living (ADL) score, and complication rates were compared between the two groups. Results: After matching, there were no significant differences in intraoperative blood loss and evacuated hematoma volume between the two groups (both Conclusion: Intracranial pressure monitoring combined with hematoma evacuation was associated with better clinical outcome, lower serum levels of ET-1, MMP-9, AOPP, and stress hormones, fewer complications, and greater independence in daily living. However, the observational design limits causal inference, and the external ventricular drain may have contributed both monitoring and therapeutic drainage effects that cannot be completely separated in this study.