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Ellis Tim - - 2006
The mean of cardiovascular pressure signals is an important metric in patient monitoring applications for many types of diseases and injuries. It is typically calculated with a moving average of 3-8 s of the pulsatile signal. This method of calculating the mean introduces a delay of 1.5-4 s. We demonstrate ...
Hu Xiao - - 2006
Causal coherence analysis was applied to beat-to-beat mean intracranial pressure (ICP) and RR interval signals that were recorded from twelve normal pressure hydrocephalus patients. Data were organized into two groups including an ICP B-Wave group and a control baseline group. Maximal classic coherence between ICP and RR interval within [0.04-0.15] ...
Balestreri Marcella M Academic Neurosurgical Unit Addenbrooke's Hospital, Cambridge, - - 2006
To investigate the relationships between intracranial pressure (ICP), cerebral perfusion pressure (CPP), and outcome after traumatic brain injury. A retrospective analysis of prospectively recorded data from 429 patients after head injury requiring intensive treatment on the Neuroscience Intensive Annex and the Neuro Critical Care Unit, Cambridge, UK. ICP, CPP, and ...
Hutchinson P J PJ Department of Neurosurgery, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK. - - 2006
The RESCUEicp (Randomized Evaluation of Surgery with Craniectomy for Uncontrollable Elevation of intracranial pressure) study has been established to determine whether decompressive craniectomy has a role in the management of patients with traumatic brain injury and raised intracranial pressure that does not respond to initial treatment measures. We describe the ...
Daley M L ML Department of Electrical and Computer Engineering, University of Memphis, Memphis, Tennessee 38152-3180, USA. - - 2006
To examine changes in cerebrovascular pressure transmission derived from arterial blood pressure (ABP) and intracranial pressure (ICP) recordings by autoregressive moving average modeling technique. Digitized ICP and ABP recordings were obtained from patients with brain injury. Two groups were defined: Group A with 4 patients who demonstrated plateau waves, and ...
Guendling K K Academic Department of Clinical Neuroscience, Addenbrooke's Hospital, Cambridge, - - 2006
To summarize our experience from the first 2 years of use of the ICM+ software in our Neurocritical Care Unit (NCCU). Ninety-five head-injured patients (74 males, 21 females), average age 36 years, were managed in the NCCU. Intracranial pressure (ICP) was monitored using Codman intraparenchymal probes and arterial blood pressure ...
Czosnyka M M Department of Clinical Neurosciences, Neurosurgical Unit, University of Cambridge, Addenbrooke's Hospital, Cambridge, UK. - - 2006
To investigate the relationships between long-term computer-assisted monitoring of intracranial pressure (ICP) and indices derived from its waveform versus outcome, age, and sex. From 1992 to 2002, 429 sedated and ventilated head-injured patients were continuously monitored. ICP and arterial blood pressure (ABP) were recorded directly and stored in bedside computers. ...
Talbert D G - - 2006
It is known that retinal haemorrhages can result in adults when elevated intrathoracic pressures due to coughing, cardiopulmonary resuscitation, etc., force blood into the head. In infants under one year of age retinal and intracranial haemorrhage commonly occur together, but the same is not true for the older child and ...
Prabhakar H - - 2005
BACKGROUND AND OBJECTIVE: The tunnelling phase of ventriculoperitoneal shunt insertion is the most painful part but patients are often given inadequate opioid analgesic for fear of post operative delayed recovery and/or respiratory depression. This may result in an increase in intracranial pressure. METHODS: Twenty adults scheduled to undergo ventriculoperitoneal shunt ...
Raabe Andreas - - 2005
OBJECT: Hypervolemia and hypertension therapy is routinely used for prophylaxis and treatment of symptomatic cerebral vasospasm at many institutions. Nevertheless, there is an ongoing debate about the preferred modality (hypervolemia, hypertension, or both), the degree of therapy (moderate or aggressive), and the risk or benefit of hypervolemia, moderate hypertension, and ...
Chansoria Maya - - 2005
Pseudotumor cerebri is a clinical syndrome characterized by raised intracranial pressure with normal ventricular size, anatomy and position. Headache, vomiting and diplopia are the most common symptoms. Signs include those of raised intracranial pressure including papilledema and absence of focal neurological signs. A secondary cause is identifiable in 50% of ...
Porter Alyx - - 2006
Increased intracranial pressure is rarely seen in association with spinal tumors. We describe a young, non-obese man who presented with increased intracranial pressure, papilledema and visual obscuration. Multiple cerebrospinal fluid (CSF) examinations with normal or minimally elevated CSF protein lead to the initial diagnosis of idiopathic intracranial hypertension. After a ...
Eide Per Kristian - - 2006
This paper describes a new method for processing of continuous pressure signals. Continuous intracranial pressure (ICP) signals were sampled at 100 Hz, converted into digital data and processed during 6s time windows. According to a new algorithm, cardiac beat-induced single ICP waves were identified; pressure waves caused by noise in ...
Kochanek Patrick M - - 2005
In 2003, a multidisciplinary group of physicians formulated the first guidelines for the management of severe traumatic brain injury in infants and children. Initial treatment of these patients is focused on stabilization to prevent the occurrence of secondary insults such as hypotension and hypoxemia. However, this article focuses on the ...
Kumar A - - 2005
OBJECTIVE: Critical closing pressure (CCP) is the arterial pressure below which the vessels collapse. Hypothetically it is the sum of intracranial pressure (ICP) and vessel wall tension in the cerebral circulation. This study investigated transhemispherical asymmetry of CCP by studying its correlation with radiological findings on computed tomography (CT) scans ...
Hlatky Roman - - 2005
OBJECTIVE: Induced hypertension is commonly used to improve cerebral perfusion, but this treatment may have the deleterious side effect of raising intracranial pressure (ICP). We tested the hypothesis that dynamic pressure autoregulation testing could identify patients who might develop increased ICP during induced hypertension. METHODS: Twenty-two studies were performed in ...
Sellner Johann - - 2006
Adverse outcome in bacterial meningitis is associated with the breakdown of the blood-brain barrier (BBB). Matrix-metalloproteinases (MMPs) facilitate this process by degradation of components of the BBB. This in turn results in acute complications of bacterial meningitis including edema formation, increased intracranial pressure and subsequent ischemia. We determined the parenchymal ...
Thomale Ulrich-Wilhelm - - 2006
OBJECTIVE: The antioxidant potential N-Acetylcysteine (NAC) and its improvement of posttraumatic mitrochondrial dysfunction have been reported. This study investigated the effect of NAC on posttraumatic changes after controlled cortical Impact (CCI) injury. DESIGN AND SETTING: Prospective randomized controlled animal study. METHODS: A moderate left focal cortical contusion was induced using ...
Eide Per Kristian - - 2006
Simultaneous continuous intracranial pressure (ICP) signals from two different sensors were compared. Continuous ICP monitoring from two ICP sensors (i.e. Codman ICP MicroSensor; Johnson & Johnson, Raynham, MA and Camino OLM ICP; Camino Laboratories, San Diego, CA) placed within the brain parenchyma was performed in three patients within the intensive ...
Cremer, Olaf Lodewijk
The main goal of neurosurgical intensive care in comatose patients with head injuries is to prevent secondary neuronal damage resulting from ischemia and tissue hypoxia. In his thesis, Olaf Cremer critically examines the rationale and risk-to-benefit ratio of aggressive manipulation of blood pressure, intracranial pressure, cerebral perfusion pressure, and temperature ...
Bloch Orin - - 2005
Brain abscess is associated with local vasogenic edema, which leads to increased intracranial pressure and significant morbidity. Aquaporin-4 (AQP4) is a water channel expressed in astroglia at the blood-brain and brain-CSF barriers. To investigate the role of AQP4 in brain abscess-associated edema, live Staphylococcus aureus (10(5) colony-forming units) was injected ...
Timofeev Ivan - - 2005
PURPOSE OF REVIEW: This article reviews recent advances in multimodality monitoring of patients following severe head injury during the period of 2004-2005. RECENT FINDINGS: Whilst intracranial pressure measurement remains the cornerstone of neuromonitoring, analysis of the intracranial pressure waveform provides additional information, which may help guide treatment and predict outcome. ...
Ware Marcus L - - 2005
OBJECTIVE: Mannitol is the standard of care for patients with increased intracranial pressure (ICP), but multiple administrations of mannitol risk renal toxicity and fluid accumulation in the brain parenchyma with consequent worsening of cerebral edema. This preliminary study assessed the safety and efficacy of small-volume injections of 23.4% sodium chloride ...
Patterson Jessica - - 2005
This case study describes the management of a 54-year-old male who presented to the Hospital of the University of Pennsylvania (HUP) with a traumatic brain injury (TBI) after being assaulted. He underwent an emergent bifrontal decompressive hemicraniectomy for multiple, severe frontal contusions. His postoperative course included monitoring of intracranial pressure, ...
March Karen - - 2005
Evidence suggests that the mortality and morbidity of acquired brain injury could be reduced if clinicians used an aggressive intracranial pressure guided approach to care. Despite nearly 50 years of evidence that intracranial pressure monitoring benefits patient care, only about half of the patients who could benefit are monitored. Some ...
Hornero Roberto - - 2005
We studied changes in intracranial pressure (ICP) complexity, estimated by the approximate entropy (ApEn) of the ICP signal, as subjects progressed from a state of normal ICP (< 20-25 mmHg) to acutely elevated ICP (an ICP "spike" defined as ICP > 25 mmHg for < or = 5 min). We ...
Sahin Soner - - 2005
Our aim was to analyze prognostic factors and their association with outcome among children with severe head injury. We conducted a retrospective study among children (n=55) with severe head injury [Glasgow Coma Score (GCS) ?8] who were admitted to our Neurosurgical Intensive Care Unit (ICU) from January 1996 to September ...
Deeren Dries H - - 2005
OBJECTIVE: To examine on the basis of a large number of measurements whether increased IAP is associated with increased ICP and decreased CPP in ventilated patients with nontraumatic brain injury. DESIGN AND SETTING: Observational clinical study in the medical and surgical intensive care unit of a tertiary teaching hospital. PATIENTS: ...
H Shemirani; Associate Professor, ...
Background: Many patients with suspected acute myocardial infarction (AMI) and eligible for thrombolytic therapy may not be treated because of association between hemorrhagic complications especially intracranial hemorrhage (ICH), and severe hypertension (HTN) at presentation. Unfortunately, this leads to under use or delay in thrombolytic therapy. We assessed effect of decreasing ...
Myburgh J A - - 2005
In traumatic brain injury, cerebral hypoperfusion is associated with adverse outcome, particularly in the early phases of management. This has resulted in the increased use of drugs such as adrenaline, noradrenaline, dopamine and phenylephrine to augment or maintain systemic blood pressures at near normal levels. This is now part of ...
Hu Xiao - - 2006
The global compliance of a fixed-volume, incompressible compartment may play a significant role in determining the inherent vascular compliance. For the intracranial compartment, we propose that the free-displacement of the cerebral spinal fluid (CSF) directly relates to cerebral vascular compliance. To test this hypothesis, an in vivo surrogate intracranial compartment ...
Chambers I R - - 2006
The principal strategy for managing head injury is to reduce the frequency and severity of secondary brain insults from intracranial pressure (ICP) and cerebral perfusion pressure (CPP), and hence improve outcome. Precise critical threshold levels have not been determined in head injured children. To create a novel pressure-time index (PTI) ...
Agren-Wilsson A - - 2005
BACKGROUND: The symptoms in idiopathic adult hydrocephalus syndrome (IAHS) are consistent with pathology involving the periventricular white matter, presumably reflecting ischaemia and CSF hydrodynamic disturbance. OBJECTIVE: To investigate whether a change in intracranial pressure (ICP) can affect energy metabolism in deep white matter. METHODS: A microdialysis catheter, a brain tissue ...
Helling Eric - - 2005
Head and neck injuries are not uncommon in combat environments and may be increasing due to survivable injuries from the use of kevlar helmets and body armor. With the current capability of rapid evacuation from the battlefield, acutely injured patients with frontal sinus injuries may undergo further barometric challenges. Proper ...
Jalan Rajiv - - 2005
In acute liver failure (ALF) patients that have raised increased intracranial pressure (ICP), mortality remains unacceptably high. There has been an explosion in the knowledge about the pathophysiological basis of raised ICP but treatment modalities are limited. Current therapy is aimed at reducing the circulating ammonia levels and attempts to ...
Clausen F - - 2005
BACKGROUND: In traumatic brain injury research, the fluid percussion injury (FPI) model in the rat is widely used. The injury is graded based on indirect criteria, such as the extracranial pressure wave and/or physiological responses to the injury. We designed this study to investigate if the extracranially monitored pressure in ...
Seppelt, Ian
Traumatic brain injury is a devastating problem with both high mortality and high subsequent morbidity. Injury to the brain occurs both at the time of the initial trauma (the primary injury) and subsequently due to ongoing cerebral ischaemia (the secondary injury). Hypotension and hypoxaemia are well recognized causes of this ...
Vincent Jean-Louis - - 2005
OBJECTIVE: To review the current understanding of the medical management of severe brain injury. DATA SOURCE: The MEDLINE database, bibliographies of selected articles, and current English-language texts on the subject. STUDY SELECTION: Studies related to management of intracranial hypertension, traumatic brain injury, and brain edema. DATA EXTRACTION: All studies relevant ...
Portella G - - 2005
BACKGROUND: Cerebral compliance expresses the capability to buffer an intracranial volume increase while avoiding a rise in intracranial pressure (ICP). The autoregulatory response to Cerebral Perfusion Pressure (CPP) variation influences cerebral blood volume which is an important determinant of compliance. The direction of compliance change in relation to CPP variation ...
Elf Kristin - - 2005
OBJECTIVE: To describe the occurrence of secondary insults using a computerized monitoring data collecting system and to investigate their relationship to outcome when the neurointensive care was dedicated to avoiding secondary insults. METHODS: Patients 16 to 79 years old admitted to the neurointensive care unit between August 1998 and December ...
Eide Per Kristian - - 2005
BACKGROUND: Intracranial compliance may be more reliably predicted by the pulsatile component (pulse pressure) than the steady (mean pressure) component of intracranial pressure (ICP). A new method of processing continuous ICP signals assessing both components of ICP is described and applied to the ICP recordings of 6 pediatric cases. METHOD: ...
Smith Michelle J - - 2005
OBJECTIVE: To determine a) whether packed red blood cell transfusion (RBCT) increases local brain tissue oxygen partial pressure (Pbto2) in a neurocritical care population; and b) what (if any) demographic, clinical, or physiologic variables mediate the assumed change. DESIGN: Prospective observational study. SETTING: A neurosurgical intensive care unit at a ...
Krave Ulrika - - 2005
A rotational acceleration impulse to a head, as occurs at traffic accidents, sport injuries, assaults and falls, induces a diffuse brain damage that eventually could result in persistent neuropsychiatric deficits and neurodegeneration. Emphasis has been concentrated on the relative motion of the brain inside the skull during head impact, whereas ...
Bourgoin Aurélie - - 2005
OBJECTIVE: The manual injection of a bolus of opioid in patients with brain injury induces an increase in intracranial pressure related to a decrease in mean arterial pressure. Such an effect has not been observed with the use of ketamine. The use of target-controlled infusion would minimize or suppress this ...
Kongstad L L Department of Anesthesia and Intensive Care, University and University Hospital of Lund, SE-221 85 Lund, - - 2005
Lumbar dural puncture may reduce intracranial pressure (ICP) due to a hydrostatic pressure gradient created by distal opening of the spinal fluid column towards the atmosphere. The magnitude of the reduction in hydrostatic force on the brain should depend on the vertical distance between the brain and the dural opening, ...
Panerai Ronney B - - 2005
Dynamic cerebral autoregulation (CA) describes the transient response of cerebral blood flow (CBF) to rapid changes in arterial blood pressure (ABP). We tested the hypothesis that the efficiency of dynamic CA is increased by brain activation paradigms designed to induce hemispheric lateralization. CBF velocity [CBFV; bilateral, middle cerebral artery (MCA)], ...
Voorhees Jennifer R - - 2005
At the end of the 19th century, the early evolution of the specialty of neurological surgery was restricted by complications related to infection, increased intracranial pressure, and excessive intraoperative blood loss. These complications often caused mortality rates of 30 to 50%. An improved understanding of pathophysiological factors involved in increased ...
Kalmar A F - - 2005
BACKGROUND: During an endoscopic neurosurgical procedure a sudden increase in intracranial pressure may occur at any time. We present a prospective study of haemodynamic changes during such procedures. METHODS: Physiological data were recorded during the whole operative procedure in 17 consecutive patients who underwent an endoscopic neurosurgical procedure under general ...
Marcoux Kelly Keefe - - 2005
Increased intracranial pressure reflects the presence of mass effect in the brain and is associated with a poor outcome in children with acute neurological injury. If sustained, it has a negative effect on cerebral blood flow and cerebral perfusion pressure, can cause direct compression of vital cerebral structures, and can ...
Dahlbacka Sebastian - - 2005
BACKGROUND: There is some evidence of beneficial metabolic effects associated with the pH-stat than with alpha-stat perfusion strategy, but this is tempered by a likely increased risk of embolism to the brain, especially in adult patients. We investigated this possible adverse effect in an experimental model that combined hypothermic circulatory ...
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