FIBEROPTIC BRONCHOSCOPY IN THE PRESENCE OF SPACE-OCCUPYING INTRACRANIAL LESIONS

The performance of flexible fiberoptic bronchoscopy (FFB) has anecdota lly been considered to carry a high risk of neurologic complications i n patients with raised intracranial pressure (ICP). There is no eviden ce in the literature to support this concern. We evaluated this risk b y reviewing hospital records of 132 patients who under-went FFB and co mputer tomography of the central nervous system (CNS-CT) during the sa me hospitalization. Twenty-nine patients had CT evidence of increased ICP. For the purpose of analysis, patients were divided into two group s: 17 patients had evidence of raised ICP prior to the performance of FFB and had received treatment with an intent to lower the ICP, and 12 patients in whom increased ICP was not suspected at the time of FFB a nd therefore did not receive any form of pretreatment. There was no ev idence of neurologic complications in either group during the first po stbronchoscopy week. We conclude that FFB carries a low risk in patien ts with elevated ICP.