Qiu WS, Chen HD, Yang WJ, Chen MM. Intracranial pressure management in severe intraventricular hemorrhage: A minireview. World J Crit Care Med 2026; 15(1): 115169 [DOI: 10.5492/wjccm.v15.i1.115169]
Corresponding Author of This Article
Wu-Si Qiu, MD, PhD, Associate Chief Physician, Associate Professor, Department of Surgical Education and Research, Affiliated Hospital of Hangzhou Normal University, No. 126 Wenzhou Road, Gongshu District, Hangzhou 310015, Zhejiang Province, China. shihai954@163.com
Research Domain of This Article
Critical Care Medicine
Article-Type of This Article
Minireviews
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Mar 9, 2026 (publication date) through Mar 3, 2026
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Journal Information of This Article
Publication Name
World Journal of Critical Care Medicine
ISSN
2220-3141
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Qiu WS, Chen HD, Yang WJ, Chen MM. Intracranial pressure management in severe intraventricular hemorrhage: A minireview. World J Crit Care Med 2026; 15(1): 115169 [DOI: 10.5492/wjccm.v15.i1.115169]
Wu-Si Qiu, Department of Surgical Education and Research, Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, Zhejiang Province, China
Wu-Si Qiu, Wen-Jie Yang, Department of Neurosurgery, Affiliated Hospital of Hangzhou Normal University, Hangzhou 310015, Zhejiang Province, China
Hao-Dong Chen, Department of Neurosurgery, Tongxiang First People’s Hospital, Jiaxing 314500, Zhejiang Province, China
Ming-Min Chen, Department of General Practice, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
Co-first authors: Wu-Si Qiu and Hao-Dong Chen.
Co-corresponding authors: Wu-Si Qiu and Ming-Min Chen.
Author contributions: Qiu WS and Chen MM designed the study, and they contributed equally to this manuscript as co-corresponding authors; Qiu WS and Chen HD contributed equally to this manuscript as co-first authors; Qiu WS, Chen HD, Yang WJ, and Chen MM performed references acquisition and interpretation; Qiu WS and Chen MM wrote the manuscript; Qiu WS, Chen HD, and Yang WJ critically revised it for important intellectual content. All authors have read and approved the final manuscript.
Supported by Scientific Research Fund of Hangzhou Health Department, No. A20251639; and Teaching Construction and Reform Projects of Hangzhou Normal University, No. JG2025180.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Wu-Si Qiu, MD, PhD, Associate Chief Physician, Associate Professor, Department of Surgical Education and Research, Affiliated Hospital of Hangzhou Normal University, No. 126 Wenzhou Road, Gongshu District, Hangzhou 310015, Zhejiang Province, China. shihai954@163.com
Received: October 14, 2025 Revised: November 5, 2025 Accepted: December 29, 2025 Published online: March 9, 2026 Processing time: 140 Days and 18.3 Hours
Abstract
Severe intraventricular hemorrhage (IVH) is a life-threatening neurological emergency that poses significant risks of morbidity and mortality, particularly due to the associated elevated intracranial pressure (ICP). Studies have shown that the incidence of IVH in very preterm infants is high, with management strategies playing a significant role in its development. Moreover, predictive models have been developed to forecast early mortality and severe IVH in very-low birth weight preterm infants, indicating the complexity and multifactorial nature of this condition. This mini-review synthesizes recent advances in the understanding of intracranial dynamics, monitoring technologies, and therapeutic strategies for managing ICP in IVH. The Monro-Kellie 4.0 framework integrates cerebrovascular autoregulation, intracranial compliance, and glymphatic clearance as core determinants of ICP. Pathophysiological mechanisms include obstructive hydrocephalus, hemoglobin-mediated neurotoxicity, and cortical spreading depolarizations. Advancements in non-invasive monitoring techniques, such as ICP monitoring and genetic testing, coupled with the integration of artificial intelligence, are significantly improving early detection capabilities and enabling more personalized management strategies. Therapeutic advances include algorithmic cerebrospinal fluid drainage, glymphatic-enhanced therapies, and precision hyperosmolar therapy. This review highlights the need for standardized protocols, large-scale trials, and artificial intelligence-driven approaches to improve outcomes in severe IVH.
Core Tip: This mini-review provides an updated synthesis of intracranial pressure management in severe intraventricular hemorrhage, introducing the innovative Monro-Kellie 4.0 framework and highlighting the integration of artificial intelligence with multimodal monitoring for personalized care. It emphasizes emerging therapeutic strategies including glymphatic enhancement, smart drainage systems, and future research directions to improve patient outcomes through precision medicine approaches.
