Reduced risk of ICA ligation after balloon occlusion test

Brain energy metabolism in global brain oedema.

Different degrees of severity in global brain oedema were induced by varying amounts of water intoxication (50, 100, 150, and 200 ml Aqua dest./kg b.wt. intravenously) in groups of six cats, which were functionally nephrectomized. Animals loaded with physiological saline and sham-operated served as controls. Two hours following the water load, the tissue concentrations of CrP, ATP, ADP, AMP, pyruvate, glucose, and lactate were determined by optical enzymatic analysis. The results show disturbances in brain energy metabolism dependent on the severity of the brain oedema. The high energy compounds and in consequence the ATP/ADP-ratio, and respectively the energy charge potential, fall in dire…

nrCBF and EEG Monitoring During Probatory Balloon Occlusion of the Internal Carotid Artery

Surgical treatment of tumors in the neck and throat rounding the carotid artery or of giant aneurysms originating from this vessel often makes ligation or resection of the internal carotid artery necessary. This procedure carries a 15%–30% morbidity from cerebral ischemia according to the literature (2, 7).

The influence of the decompressive operation on the intracranial pressure and the pressure-volume relation in patients with severe head injuries.

Measurements of intracranial pressure by ventricular catheter were performed in 47 patients with severe head injuries. Thirty-three patients with decompressive operations such as osteoclastic craniotomy and dilatation by means of duraplastic have been compared with 14 patients with closed heads with regard to volume pressure response (intracranial elasticity). This was determined either by intraventricular injection of 2 ml saline or by drainage of cerebrospinal fluid. The examination clearly shows that patients with closed heads have a much higher intracranial elasticity than patients who have decompressive operations, so that in the first group minor differences of the intracranial volume…

Risk and Benefit of STA/MCA Anastomoses

The advantage of EC/IC operation has not yet been proved unequivocally enough. We therefore attempted to analyze our cases in order to establish the possible benefit and risk of the operation. We compared the outcome of the operated and nonoperated patients with reference to the literature.

The Effect of Dexamethasone and Diuretics on Peritumor Brain Edema: Comparative Study of Tissue Water Content and CT

Eighteen brain tumor patients were pre-operatively treated with dexamethasone, 4 × 4 mg i.m. for 4–6 days, and furosemide, 3 × 40 mg p.o. for 2–4 days. Water and electrolyte content were determined in biopsies removed from peritumoral cortex and white matter during operation and compared with the results from 31 patients not pre-treated and 28 patients treated with dexamethasone alone (16–24 mg i.m./day for 4–6 days). While the water content in cortex did not change significantly it fell in white matter from 79.90 ± 0.81 in untreated to 77.29 ± 0.76 in dexamethasone-treated and to 75.53 ± 1.03 in patients treated with a combination of dexamethasone and furosemide. With the diminution of wat…

nrCBF for Timing of Angiography and Operation in Subarachnoid Hemorrhage

Early operation on cerebral aneurysms is demanded not least because of the threat of spasm of the cerebral vessels. As is generally recognized, this is to be expected in a very high percentage within a few days after the first aneurysm hemorrhage and frequently cannot be diagnosed clinically (4, 5). Many neurosurgeons have rated the risk of operating in the presence of vasospasm so high that, like C.G. DRAKE in 1975 (2), they demanded control angiography with its own risk, especially in existing vasospasm in early angiography and the aneurysm operation itself could not take place rapidly.