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Yannopoulos Demetris D Department of Cardiology, University of Minnesota, Minneapolis, Minnesota, - - 2006
To evaluate the potential to use subatmospheric intrathoracic pressure to regulate intracranial pressure (ICP) in normovolemic and hypovolemic animals, we tested the hypothesis that mechanical devices designed to reduce intrathoracic pressure will decrease ICP in a dose-related manner. An inspiratory impedance threshold device was used in spontaneously breathing animals and ...
Mitchell Patrick - - 2007
To determine the statistical characteristics of blood pressure (BP) readings from a large number of head-injured patients. The BrainIT group has collected high time-resolution physiological and clinical data from head-injured patients who require intracranial pressure (ICP) monitoring. The statistical features of this dataset of BP measurements with time resolution of ...
Eide P K - - 2006
OBJECT: To relate intracranial pressure (ICP) levels and single ICP wave amplitudes to the acute clinical state (Glasgow Coma Score, GCS) and final clinical outcome (Glasgow Outcome Score, GOS) in patients with subarachnoid haemorrhage (SAH). METHODS: Twenty-seven consecutive patients with severe SAH had their ICP and arterial blood pressure (ABP) ...
Dohmen Christian - - 2007
BACKGROUND AND PURPOSE: To study cerebrovascular autoregulation and its impact on clinical course in patients with impending malignant middle cerebral artery infarction, we used invasive multimodal neuromonitoring, including measurement of cerebral perfusion pressure, tissue oxygen pressure, and microdialysis. METHODS: Fifteen patients with a stroke that involved >50% of the middle ...
Latka, M.
We employ complex continuous wavelet transforms to develop a consistent mathematical framework capable of quantifying both cerebrospinal compensatory reserve and cerebrovascular pressure reactivity. The wavelet gain, defined as the frequency dependent ratio of time averaged wavelet coefficients of intracranial pressure (ICP) and arterial blood pressure (ABP) fluctuations, characterizes the dampening ...
Ko┼║niewska E - - 2006
The main consequence of subarachnoid hemorrhage, for those who survive bleeding, is delayed, persistent vasospasm of intracranial conduit arteries which occurs between the third and seventh day after the insult and results in symptomatic brain ischemia in about 40% of cases. This vasospasm is considered to be a major cause ...
Enam Syed Ather - - 2006
Cerebral venous sinus thrombosis (CVST) usually is taken care of by medical management or neuro-interventional vascular techniques. Some cases of CVST may take a malignant course if the intracranial pressure increases excessively. This increase in pressure is because of oedema in brain tissue due to impediment in venous return and/or ...
Fodstad Harald - - 2006
Increasing systolic and pulse pressure with bradycardia and respiratory irregularity are signs of increased intracranial pressure, leading to cerebral herniation and fatal brainstem compression. This phenomenon, the vasopressor response, is generally known as the Cushing reflex based on Harvey Cushing's experimental work in Europe in 1901 and 1902. However, similar ...
Kirkness Catherine J - - 2006
BACKGROUND: Clinical bedside monitoring systems do not provide prominent displays of data on cerebral perfusion pressure (CPP). Immediate visual feedback would allow more rapid intervention to prevent or minimize suboptimal pressures. OBJECTIVE: To evaluate the effect of a highly visible CPP display on immediate and long-term functional outcome in patients ...
Splavski Bruno B Division of Neurosurgery, Clinical Hospital, Osijek, Croatia. - - 2006
To investigate the potential of transcranial Doppler ultrasonography in estimating post-traumatic intra-cranial pressure early after severe traumatic brain injury. The group of 24 patients was analysed for the observation of an early post-traumatic cerebral haemodynamic by middle cerebral artery blood velocity measuring. The standard method of measuring the mean blood ...
Foss Tonje - - 2007
BACKGROUND/AIMS: Previous research has shown improvements in the clinical triad (gait, incontinence and cognitive dysfunction) after shunt surgery in idiopathic normal pressure hydrocephalus (iNPH) patients with intracranial pulse pressure amplitudes >4-5 mm Hg, the pulse amplitudes being <4 mm Hg in the nonresponders. However, it is unknown whether similar differences ...
Stevens Scott A - - 2007
Idiopathic intracranial hypertension (IIH) is a syndrome of unknown etiology characterized by elevated intracranial pressure (ICP). Although a stenosis of the transverse sinus has been observed in many IIH patients, the role this feature plays in IIH is in dispute. In this paper, a lumped-parameter model is developed for the ...
Ang B T - - 2007
OBJECTIVE: To investigate the temporal relationship between cerebrovascular pressure reactivity and brain tissue oxygenation in patients with severe head injury. METHODS: In 40 patients, brain tissue oxygenation and intracranial pressure were monitored. Time-averaged values for intracranial pressure (ICP), mean arterial pressure (MAP), cerebral perfusion pressure (CPP) and brain tissue oxygenation ...
Randell Tarja - - 2006
PURPOSE OF REVIEW: The recent literature on the perioperative maintenance of cerebral homeostasis was reviewed. RECENT FINDINGS: Several studies focused on the regulation of cerebral blood flow in patients without intracranial disease; therefore, further studies in neurosurgical patients are needed. High intracranial pressure and brain swelling can be controlled by ...
Engelhard Kristin - - 2006
PURPOSE OF REVIEW: In neurosurgery, anesthesiologists and surgeons focus on the same target - the brain. The nature of anesthetics is to interact with brain physiology, leading to favorable and adverse effects. Research in neuroanesthesia over the last three decades has been dedicated to identifying the optimal anesthetic agent to ...
Rangel-Castillo Leonardo - - 2006
Effective treatment of intracranial hypertension involves meticulous avoidance of factors that precipitate or aggravate increased intracranial pressure. When intracranial pressure becomes elevated, it is important to rule out new mass lesions that should be surgically evacuated. medical management of increased intracranial pressure should include sedation and paralysis, drainage of cerebrospinal ...
Tayal Vivek S - - 2007
STUDY OBJECTIVE: Our objective is to determine whether a bedside ultrasonographic measurement of optic nerve sheath diameter can accurately predict the computed tomographic (CT) findings of elevated intracranial pressure in adult head injury patients in the emergency department (ED). METHODS: We conducted a prospective, blinded observational study on adult ED ...
Leal-Noval Santiago Ramón - - 2006
OBJECTIVE: To investigate the long-term influence of erythrocyte transfusion on cerebral oxygenation in patients with severe traumatic brain injury. DESIGN: Prospective and observational study. SETTING: Neurotrauma intensive care unit of trauma center level I. PATIENTS: Sixty consecutive, hemodynamically stable patients with severe traumatic brain injury, pretransfusion hemoglobin<100g/l, non-bleeding and monitored ...
Thelandersson A - - 2006
BACKGROUND: Prone position has been used for several years to treat acute lung insufficiency, but in previous studies patients with unstable intracranial pressure (ICP) are mostly excluded. The aim of this study was to investigate if prone position is a safe and useful treatment in patients with reduced intracranial compliance. ...
Eigsti Janice - - 2006
The skull is a unique part of anatomy. It exists in a state of dynamic equilibrium. The components of the skull and their role in maintaining integrity and normal intracranial pressure will be reviewed in this article. Compensatory mechanisms that attempt to prevent the destructive effects of cerebral ischemia and ...
Nekludov M - - 2006
BACKGROUND: Treatment of patients in the prone position is a well-established method to improve oxygenation in general intensive care unit (ICU) practice. This method is rarely used in a neurosurgical ICU, considering the risk of intracranial hypertension. The aim of this study was to analyse the effect of prone position ...
Chavko Mikulas - - 2007
Exposure to blast wave that is generated during an explosion may result in brain damage and related neurological impairments. The aim of this study was to investigate pressure changes induced by exposure to blast inside the rat brain. For intracranial pressure measurement we used a miniature optic fiber sensor (o.d. ...
Shinder Roman - - 2006
A 54-year-old non-obese woman treated with amiodarone reported blurred vision and had bilateral optic disc edema with relative preservation of visual function. Neurologic examination, brain imaging, and lumbar puncture opening pressures were normal, effectively ruling out increased intracranial pressure. Amiodarone was discontinued and the optic disc edema completely resolved over ...
Roher Alex E - - 2006
OBJECTIVE: Recent post-mortem studies have reported that the severity of atheromatous deposits in the circle of Willis is significantly greater, relative to non-demented (ND) elderly persons, in subjects with neuropathologically diagnosed Alzheimer's disease (AD). Additionally, the severity of intracranial atherosclerosis correlates significantly with the densities of neuritic plaques and neurofibrillary ...
David M - - 2006
BACKGROUND: Current practice at high-frequency oscillatory ventilation (HFOV) initiation is a stepwise increase of the constant applied airway pressure to achieve lung recruitment. We hypothesized that HFOV would lead to more adverse cerebral haemodynamics than does pressure controlled ventilation (PCV) in the presence of experimental intracranial hypertension (IH) and acute ...
Yannopoulos Demetris - - 2006
BACKGROUND: The intrathoracic pressure regulator (ITPR) was created to improve hemodynamics by generating continuous negative airway pressure between positive pressure ventilations to enhance cardiac preload in apnoeic animals. In normovolemic and hypovolemic pigs, we tested the hypothesis that continuous negative intrathoracic pressure set at -5 or -10mmHg, interrupted only for ...
Salci Konstantin - - 2006
OBJECTIVE: The vulnerability of the brain is considered to be increased after trauma. The present study was undertaken to determine whether intracranial volume insults in the posttraumatic period led to increased metabolic disturbances if intracranial compliance was decreased. METHODS: A weight drop technique with a brain compression of 1.5 mm ...
Shieh Jiann-Shing - - 2006
This paper assesses the controller performance of a self-organizing fuzzy logic controller (SOFLC) in comparison with a routine clinical rule-base controller (RBC) for sedation control of intracranial pressure (ICP) pattern. Eleven patients with severe head injury undergoing different neurosurgeries in a neurosurgical intensive care unit (NICU) were divided into two ...
Karakoulas Konstantinos A - - 2006
Multitrauma patients commonly develop abdominal compartment syndrome, which is defined as the end result of sustained, uncorrected, intra-abdominal hypertension. We aimed to assess the effects of increased intra-abdominal pressure (IAP) upon intracranial pressure (ICP) and cerebral perfusion pressure (CPP) in the presence or absence of lipopolysacharide (LPS)-induced endotoxemia using an ...
Baussart B - - 2006
Bacterial meningitis is still associated with a high mortality, mainly because of cerebral herniation as a result of increased intracranial pressure. Published data stress the necessity of an early diagnosis and immediate start of antibiotic therapy. Nevertheless, there are only few reports in which therapeutic strategy was based on the ...
Geeraerts Thomas - - 2006
The aim of this study was to describe, in rats, brain energy metabolites changes after different levels of head trauma (T) complicated by hypoxia-hypotension (HH). Male Sprague Dawley rats (n = 7 per groups) were subjected to T by impact-acceleration with 450-g weight drop from 1.50 or 1.80 m (T ...
Cavanaugh James T JT Department of Physical Therapy and Occupational Therapy, Duke University Medical Center, Durham, NC, USA. - - 2006
The return-to-play decision after sport-related cerebral concussion depends in part on knowing when an athlete has fully recovered postural control after injury. To describe the postconcussion recovery of postural control using approximate entropy (ApEn), a regularity statistic from nonlinear dynamics. Retrospective case series analysis. Sports medicine research laboratory. Collegiate athletes ...
Pearce J M S - - 2006
James Collier, in 1904, gave one of the best early accounts of tonsillar herniation as a terminal event caused by raised intracranial pressure. He also observed false localizing signs. Adolf Meyer added to the picture, describing detailed pathology of tentorial and subfalcial herniation, and hemianopia as a false localizing sign. ...
Nortje J - - 2006
Cerebral ischaemia is implicated in poor outcome after brain injury, and is a very common post-mortem finding. The inability of the brain to store metabolic substrates, in the face of high oxygen and glucose requirements, makes it very susceptible to ischaemic damage. The clinical challenge, however, remains the reliable antemortem ...
Jaeger Matthias - - 2006
OBJECTIVE: To evaluate whether two newly developed indexes of brain tissue oxygen pressure reactivity (ORx and bPtio2) provide information on the status of cerebrovascular autoregulation after traumatic brain injury. This was accomplished by analyzing the relationship between these indexes and an index of cerebrovascular pressure reactivity (PRx). PRx is an ...
Huang Sheng-Jean - - 2006
BACKGROUND: The present study was undertaken to evaluate the efficacy and safety of hypertonic saline (HS) in the treatment of intracranial hypertension after severe head injury. METHODS: This prospective, observational study was performed in an 11-bed neurosurgery intensive care unit of a teaching hospital. From February 2002 to September 2004, ...
Filho Joel Avancini Rocha - - 2006
During orthotopic liver transplantation for fulminant hepatic failure, some patients may develop sudden deterioration of cerebral perfusion and oxygenation, mainly due to increased intracranial pressure and hypotension, which are likely responsible for postoperative neurological morbidity and mortality. In the present study, we hypothesized that the favorable effects of hypertonic saline ...
Dal Didem D Department of Anaesthesiology, Hacettepe University Faculty of Medicine, Ankara, Turkey. - - 2006
Choroidal melanoma is the most common primary intraocular cancer in adults. A sixty-nine years old, hypertensive male with a choroidal melanoma underwent enucleation. After extubation he woke up confused and unconscious. An emergent computed tomographic (CT) scan demonstrated intracerebral hematoma. The underwent repeat surgery in the postoperative first hour, because ...
Schmieder K - - 2006
Blood pressure management in patients undergoing surgery for clipping of aneurysms is demanding. More information about the ability of cerebral vessels to normally regulate cerebral blood flow may have a direct influence on the intraoperative management. In patients with subarachnoid hemorrhage (SAH) a disturbance of cerebral autoregulation has been reported ...
Hiler Magdalena M Academic Neurosurgical Unit, Department of Clinical Neuroscience, University of Cambridge, Addenbrooke's NHS Trust, Cambridge, United - - 2006
The authors explored the relationship between computerized tomography (CT) scan findings and intracranial pressure (ICP) measurements obtained in the first 24 hours of monitoring to identify parameters predicting outcome in patients with severe traumatic brain injury (TBI). Intracranial pressure, mean arterial blood pressure, cerebral perfusion pressure (CPP), and pressure reactivity ...
Turner Carole L - - 2006
OBJECT: Patients with intracranial aneurysms tend toward raised blood pressure and abnormal pulse pressure profiles. The authors have investigated the influence of three antihypertension agents on blood pressure and pulse pressure waveforms in patients with known intracranial aneurysms, with a view to assessing the potential benefits of longterm antihypertension therapy ...
Korsic Marjan - - 2006
AIM: To investigate the relation between metabolic parameters of the brain tissue, as direct indicators of real metabolic conditions within the brain, and intracranial pressure, as the consequence of pathophysiological changes. METHODS: Twelve patients with closed head injuries were followed up for 24 hours after injury. A Codman parenchymal intracranial ...
Wartenberg Katja E - - 2006
BACKGROUND: Reversible leukoencephalopathy syndrome (RLS) is an acute neurological syndrome associated with altered mental status and visual disturbances described in patients with sudden elevations in systemic blood pressure and other medical conditions. In this process, neuroimaging studies usually demonstrate diffuse edema involving the subcortical structures of the posterior regions of ...
Feltracco P - - 2006
Fulminant hepatic failure (FHF) is often complicated with cerebral edema, intracranial hypertension, and coma. Cytotoxic and vasogenic factors have been recognized in the etiology of cerebral edema. One of the main causes seems to be the accumulation of glutamine in astrocytes, which is produced from ammonia and the excitatory neurotransmitter ...
Kuzak Nick - - 2006
Autoregulation is dysfunctional in the injured brain. Increases in intracranial and arterial pressure may therefore result in extension of the primary injury. Rapid sequence intubation (RSI) is a well-known cause of surges in both arterial pressure and intracranial pressure. Neuroprotective agents, namely lidocaine and fentanyl, have the potential to minimize ...
Friedman Deborah I - - 2006
Increased pressure in the dural venous sinuses has been proposed as the cause of increased intracranial pressure in the condition known as idiopathic intracranial hypertension (IIH). This hypothesis has received further support from manometry of the dural venous sinuses, showing a substantial proximal-to-distal pressure gradient, and from reports of improvement ...
Grosse-Wortmann L - - 2006
Arrhythmias occur as a life-threatening complication in adults with severe head injuries. A wide spectrum of brady- and tachyarrhythmias and different pathogenetic mechanisms have been described. We report an 8-year-old boy with traumatic brain injury who developed a variety of independent types of arrhythmias during the course of his illness, ...
Narotam Pradeep K - - 2006
INTRODUCTION: Trauma is the commonest cause of death in the pediatric population, which is prone to diffuse primary brain injury aggravated by secondary insults (eg, hypoxia, hypotension). Standard monitoring involves intracranial pressure (ICP) and cerebral perfusion pressure, which do not reflect true cerebral oxygenation (oxygen delivery [Do(2)]). We explore the ...
Tabuchi Sadaharu - - 2006
OBJECTIVES: Changes in systemic arterial blood pressure and the degree of cerebral vasospasm were investigated in 125 patients with aneurysmal subarachnoid hemorrhage. METHODS: Systemic arterial blood pressure was measured every 2 hours in each patient for a period of more than 2 weeks, and a fall in systemic blood pressure ...
Su Chain-Fa - - 2006
In subarachnoid hemorrhage (SAH), Cushing postulated that the increase in systemic arterial pressure (SAP) in response to elevation of intracranial pressure (ICP) was beneficial to cerebral perfusion. However, in uncontrolled SAH, the increased SAP may cause more bleeding into the subarachnoid space and further increase the ICP. We created an ...
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