Search results for "intracranial pressure"
showing 10 items of 82 documents
Electrical Impedance, ICP and Histology in Rats with Sagittal Sinus Occlusion
1993
The diversity of clinical symptoms developing after thrombosis of the cerebral superior sagittal sinus is not well understood [2, 4], This is largely related to our ignorance of the underlying pathophysiology. An improvement in the pathophysiological understanding can be expected by experimental studies. Although animal models are available fot that purpose they are, however, in short supply. A few years ago, our laboratory in collaboration with the department of neurology at the University of Munich made another attempt to establish a reproducible experimental model for the induction of thrombosis of the superior sagittal sinus in rats. In the present studies this model has been used to ev…
Neurosurgery of Malignant Brain Tumors
1987
To Virchow 167 belongs the credit of identifying as tumors, tissue changes already described in the brain, and at the same time to have published an account of the characteristics of the gliomas and the first classification of the various types. It was only the knowledge of the neoplastic nature of the gliomas 127 which made possible surgical action with the aim of extirpation (Fig. 1), when at the end of the 19th century the stormy development of surgery in other parts of the body was being practised successfully 162. The first reports about the removal of an intracerebral space-occupying lesion came from Wernicke and Hahn (1881)183 and also from Bennett and Godley (1884)16. In both cases …
Ten physiological commandments for severe head injury
2020
Advances in multiparametric brain monitoring have allowed us to deepen our knowledge of the physiopathology of head injury and how it can be treated using the therapies available today. It is essential to understand and interpret a series of basic physiological and physiopathological principles that, on the one hand, provide an adequate metabolic environment to prevent worsening of the primary brain injury and favour its recovery, and on the other hand, allow therapeutic resources to be individually adapted to the specific needs of the patient. Based on these notions, this article presents a decalogue of the physiological objectives to be achieved in brain injury, together with a series of …
Organisation of care and initial management of severe head injury in Spain: Results of a national survey
2016
Abstract Objective The main objective of the study is to obtain knowledge about the organisation of care for severe head trauma as well as the initial management of these patients in Neurosurgical Departments in Spain. Material and method A 22-item questionnaire was designed and sent to 59 Neurosurgical Departments. The aim of the questionnaire was to collect data regarding the general profile of the patients with a severe head injury, the general characteristics of the hospitals, the initial care of these patients, the monitoring techniques used, and the measures used to control Intracranial pressure (ICP). Results Of the 59 Neurosurgical Departments identified, 29 (49.2%) completed the qu…
Lung Injury Is a Predictor of Cerebral Hypoxia and Mortality in Traumatic Brain Injury
2020
Background: A major contributor to unfavorable outcome after traumatic brain injury (TBI) is secondary brain injury. Low brain tissue oxygen tension (PbtO2) has shown to be an independent predictor of unfavorable outcome. Although PbtO2 provides clinicians with an understanding of the ischemic and non-ischemic derangements of brain physiology, its value does not take into consideration systemic oxygenation that can influence patients' outcomes. This study analyses brain and systemic oxygenation and a number of related indices in TBI patients: PbtO2, partial arterial oxygenation pressure (PaO2), PbtO2/PaO2, ratio of PbtO2 to fraction of inspired oxygen (FiO2), and PaO2/FiO2. The primary aim …
Intensive Care Management of Head-Injured Patient
2019
Traumatic brain injury (TBI) plays an important role for the prognosis of multiple injured patients. Severely injured patients require intensive care treatment to support organ function and to maintain normal brain physiology. Optimal treatment is a cornerstone for good outcome. Therefore, in addition to general principles and concepts of modern intensive care medicine, special brain-specific aspects need to be addressed in these patients. Essential aspects of physiological regulation of cerebral perfusion and intracranial pressure as well as recent publications are reviewed as basis for current trends in the management of TBI patients. Focusing on single parameters such as intracranial pre…
Ungewöhnlicher Verlauf von otobasalen Frakturen mit Liquorrhoe*
1993
In the literature the persistence of cerebrospinal Liquorrhea after temporal bone fractures is a rare event. Between 1989 and 1992 four cases of temporal bone fractures with dural involvement were operated at the University ENT Department Mainz. These temporal bone fractures showed delayed or persistent symptoms of dural lacerations between three and sixty months after head injury. During operation we found larger bone-dura defects (1-1.5 cm in diameter) and brain herniations in all cases. Strohm stated that only in rare cases a temporal bone fracture produced a larger gap in the tegmen tympani or antri. Therefore, we assumed that in our cases such larger bone-dura defects were caused by a …
“Small Volume Resuscitation” as Treatment of Cerebral Blood Flow Disturbances and Increased ICP in Trauma and Ischemia
1996
“Small volume resuscitation” (SVR) is a promising concept for the treatment of shock and trauma patients. SVR utilizes the fast infusion of a small volume of hypertonic saline to mobilize intraendothelial and parenchymal water to expand and restitute intravascular volume. Therefore it seems warranted to also consider SVR for the treatment of disturbances of the cerebral circulation and of increased intracranial pressure (ICP). The current study uses a rabbit model of global cerebral ischemia combined with mild hemorrhage to test SVR. Somatosensory evoked potentials (SEPs) serve as a short-term outcome parameter. The data demonstrate a beneficial effect on ICP, a better reperfusion, and an i…
Brain Oedema and Intracranial Pressure in Superior Sagittal Sinus Balloon Occlusion. An Experimental Study in Pigs
1990
About 2/3 of all patients with thrombosis of the superior sagittal sinus (SSS) develop signs of increased ICP and/or brain oedema (BE). The time of onset and the spectrum of symptoms in SSS thrombosis vary extremely. This variability might be caused by differences in pathomechanism like BE and rise of ICP, parameters studied in the present contribution.
Usefulness of Cerebral Oximetry in TBI by NIRS
2021
Measurement of cerebral oximetry by near-infrared spectroscopy provides continuous and non-invasive information about the oxygen saturation of haemoglobin in the central nervous system. This is especially important in the case of patients with traumatic brain injuries. Monitoring of cerebral oximetry in these patients could allow for the diagnosis of inadequate cerebral oxygenation caused by disturbances in cerebral blood flow. It could enable identification of episodes of hypoxia and cerebral ischemia. Continuous bedside measurement could facilitate the rapid diagnosis of intracranial bleeding or cerebrovascular autoregulation disorders and accelerate the implementation of treatment. Howev…