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Kitzberger Reinhard - - 2009
BACKGROUND & AIMS: Ionized ammonia (NH(3)) and partial pressure of the gaseous ammonia (pNH(3)) are associated with hepatic encephalopathy and intracranial hypertension in patients with acute liver failure; NH(3) is also believed to contribute to extrahepatic organ failure. We investigated whether the severity of organ failure was associated with intracranial ...
Singhi Sunit C - - 2009
Raised intracranial pressure (ICP) is a life threatening condition that is common to many neurological and non-neurological illnesses. Unless recognized and treated early it may cause secondary brain injury due to reduced cerebral perfusion pressure (CPP), and progress to brain herniation and death. Management of raised ICP includes care of ...
Chen Liang - - 2009
OBJECTIVE: To investigate the cause of intracranial dural arteriovenous fistula, focusing on the role of angiogenic factors and local chronic brain hypoperfusion. METHODS: One hundred twenty rats were assigned to 4 groups: group A (n = 35), the venous hypertension group; group B (n = 35), the venous hypertension and ...
Wagshul Mark E - - 2009
OBJECT: The intracranial pulse pressure is often increased when neuropathology is present, particularly in cases of increased intracranial pressure (ICP) such as occurs in hydrocephalus. This pulse pressure is assumed to originate from arterial blood pressure oscillations entering the cranium; the fact that there is a coupling between the arterial ...
Chaiwat Onuma - - 2009
Little is known regarding the cerebral autoregulation in pediatric traumatic brain injury (TBI). We examined the relationship between cerebral hemodynamic predictors, including cerebral autoregulation, and long-term outcome after severe pediatric TBI. After Institutional Review Board (IRB) approval, a retrospective analysis of prospectively collected data (May 2002 to October 2007) for ...
Kirkness Catherine J CJ University of Washington, Seattle, USA. - - 2009
Care of brain-injured patients in intensive care units has focused on maintaining arterial blood pressure and intracranial pressure within prescribed ranges. Research suggests, however, that the dynamic variability of these pressure signals provides additional information about physiological functioning and may reflect adaptive capacity. To see if long-term outcomes can be ...
Hickey Joanne V - - 2009
Cerebral compliance is a measure of cerebral adaptability to increases in volume within the intracranial space and an indicator of risk for neurological deterioration. However, no direct measurement of compliance exists in clinical practice to guide nursing care or treatment decisions. Current use of mean intracranial pressure (MICP) and gross ...
Kumar Gyanendra - - 2009
There is paucity of data evaluating intracranial pressure (ICP) rise and its management in acute viral encephalitis (AVE). Noteworthy is the current prevalence of unselective and broad utilization of ICP lowering therapies in clinical practice. Trends in current management of ICP in AVE emanate from data extrapolated from results of ...
Geeraerts Thomas - - 2009
Raised intracranial pressure (ICP) is a frequent condition in many medical and surgical situations and is often difficult to detect. Noninvasive estimates of raised ICP are of interest to allow rapid detection of significant intracranial hypertension. In the anterior part of the optic nerve, the sheath is distensible and can ...
Huschak Gerald - - 2009
OBJECTIVE: The study presented evaluated the first clinical use of a new multiparameter catheter measuring intracranial pressure (ICP), partial pressure of brain tissue oxygen (ptiO2), and brain temperature (TBr) (Neurovent PTO). To assess the validity of measured ptiO2 a second probe, which represents the current golden standard of ptiO2 measurement, ...
Lindner U - - 2009
In this article we report on two patients with arachnoid cysts previously treated by shunt implantation presenting with clinical signs of an increased intracranial pressure i. e., papilledema, headache and nausea. Repeated MRI scans showed no alteration of the cerebrospinal fluid circulation and no space-occupying effect of the cysts. Although ...
Kelly Stephen J - - 2009
Pseudotumor cerebri, also termed idiopathic intracranial hypertension, is defined by increased intracranial pressure in the setting of normal brain imaging and cerebrospinal fluid analysis. It can often be associated with optic nerve head edema. Several medications have been associated with pseudotumor cerebri,(1) including the use of lithium carbonate in the ...
Mourad Pierre D - - 2009
Pressure within the cranium (intracranial pressure, or "ICP") represents a vital clinical variable whose assessment-currently via invasive means-and integration into a clinical exam constitutes a necessary step for adequate medical care for those patients with injured brains. In the present work we sought to develop a non-invasive way of predicting ...
Brady Ken M KM Johns Hopkins University School of Medicine, Department of Anesthesiology, Division of Pediatric Anesthesiology and Critical Care Medicine, 600 North Wolfe St., Blalock 904, Baltimore MD 21287, USA. - - 2009
The cerebral perfusion pressure that denotes the lower limit of cerebral blood flow autoregulation (LLA) is generally considered to be equivalent for reductions in arterial blood pressure (ABP) or increases in intracranial pressure (ICP). However, the effect of decreasing ABP at different levels of ICP has not been well studied. ...
Jamal Nausheen - - 2009
To date, major works on tracheomalacia have assumed a structural etiology and have proposed therapies as such. We describe a possible neurologic etiology for tracheomalacia in a child with clinically significant tracheomalacia that resolved in synchrony with each treatment of his recurring hydrocephalus. Endoscopy confirms remarkable expansion of tracheal diameter ...
da Silva Joacil Carlos - - 2010
BACKGROUND: Medical management of brain edema and elevated intracranial pressure (ICP) is a crucial challenge in neurosurgical practice. Depending on the cause, the treatments for brain edema fall into three categories: stabilization of the blood-brain barrier, depletion of brain water and surgical decompression. Although mannitol is the mainstay of hyperosmolar ...
Li Chunyan - - 2009
A novel lab-on-a-tube integrated with spirally-rolled pressure, temperature, oxygen and glucose microsensors is described for multimodal neuromonitoring of patients with traumatic brain injury. In addition to measuring various crucial parameters in real-time continuous formats, the newly developed device also works as an intraventricular catheter to lower the elevated intracranial pressure ...
Granger Robert H - - 2009
A 14-year-old girl had a 3-month history of headache and blurred vision. Funduscopy showed bilateral optic disc edema. Findings on brain imaging were normal, and a diagnosis of idiopathic intracranial hypertension was confirmed after lumbar puncture showed an elevated opening pressure of 32 cm H(2)O. Optic nerve head drusen were ...
Olson DaiWai M - - 2009
BACKGROUND: Treatment of brain injury is often focused on minimizing intracranial pressure, which, when elevated, can lead to secondary brain injury. Chest percussion is a common practice used to treat and prevent pneumonia. Conflicting and limited anecdotal evidence indicates that physical stimulation increases intracranial pressure and should be avoided in ...
Byard Roger W - - 2009
To study the speed of development of cerebral edema in an animal model, five 2-year-old male anesthetized Merino sheep were impacted in the left temporal region by a humane stunner. Following the induction of blunt craniocerebral trauma a highly significant increase in intracranial pressure (ICP) values occurred relative to control ...
López-Magaña Jorge A JA Department of Clinical Neurosciences, Neurosurgery Unit, Addenbrooke's Hospital, University of Cambridge, Cambridge, - - 2009
Critical closing pressure (CCP) is an arterial pressure threshold below which small arterial vessels collapse. Our aim was to compare different methods to estimate CCP in the cerebrovascular circulation using the relationships between transcranial Doppler flow velocity (FV), laser-Doppler flux (LDF), and arterial blood pressure (ABP). A total of 116 ...
Oddo M - - 2009
BACKGROUND: The impact of osmotic therapies on brain oxygen has not been extensively studied in humans. We examined the effects on brain tissue oxygen tension (PbtO(2)) of mannitol and hypertonic saline (HTS) in patients with severe traumatic brain injury (TBI) and refractory intracranial hypertension. METHODS: 12 consecutive patients with severe ...
Lee Jennifer K JK Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, - - 2009
The pressure reactivity index (PRx) describes cerebral vessel reactivity by correlation of slow waves of intracranial pressure (ICP) and arterial blood pressure. In theory, slow changes in the relative total hemoglobin (rTHb) measured by near-infrared spectroscopy are caused by the same blood volume changes that cause slow waves of ICP. ...
Tango Humberto K - - 2009
BACKGROUND: Brain injury is responsible for significant morbidity and mortality in trauma patients, but controversy still exists over optimal fluid management for these patients. This study aimed to investigate the effects of acute hemodilution with hydroxyethyl starch (HES) or lactated Ringer's solution (LR) in intracranial pressure (ICP) and cerebral perfusion ...
Nedelmann Max - - 2009
The pathophysiology of elevated intracranial pressure in idiopathic intracranial hypertension (IIH) is unclear. Cerebral venous outflow obstruction and elevated intracranial venous pressure may play an etiological role. We examined jugular valve insufficiency as a potential factor contributing to intracranial hypertension. Jugular venous valve function was assessed bilaterally by duplex sonography ...
Stone Michael B - - 2009
Bedside ultrasound has been used to identify intracranial hypertension through the measurement of optic nerve sheath diameter. This case report describes the sonographic detection of papilledema and a wide optic nerve sheath in a patient with pseudotumor cerebri who presented to the Emergency Department with headache and photophobia, and in ...
Jiang Ji-Yao - - 2009
Clinical randomized controlled trials (RCTs) suggest that mild hypothermia may improve the outcome of severe traumatic brain injured patients with intracranial hypertension when cooling is maintained for longer than 48 h. However, the results are not yet conclusive, and more RCTs are required. Mild hypothermia significantly decreases intracranial pressure (ICP) ...
Freitas Pedro - - 2009
We consider the model originally proposed by Shah and Humphrey (J Biomech 32:593-599, 1999) for a class of intracranial saccular aneurysms and show that for constant pressure the addition of the viscoelastic term corresponding to the presence of cerebral spinal fluid outside the membrane, no matter how small, does ensure ...
Imperiale Carmela - - 2009
BACKGROUND: Tracheostomy is commonly required as part of the management of patients with severe brain damage. Percutaneous dilation tracheostomy is increasingly used in intensive care unit as an alternative to standard surgical tracheostomy. However, this procedure carries the risk of neurological complications, particularly in patients with intracranial hypertension. In this ...
Silasi Gergely - - 2009
Stroke and traumatic brain injuries often lead to cerebral edema and persistent elevations in intracranial pressure (ICP) that can be life threatening. Thus, rodent models would benefit from a simple and reliable method to measure ICP in awake, mobile animals. Up to now most techniques have been limited to anesthetized ...
Holm Sverre - - 2009
Time domain analysis of the intracranial pressure (ICP) waveform is critically dependent on the exact reproduction of the ICP waveform. This study explored how the sampling rate of the ICP signal affects the time domain analysis. It was also assessed through this study how upsampling (interpolation) improves the time domain ...
Le Audrey - - 2009
STUDY OBJECTIVE: We investigate the test performance of emergency physician-performed sonographic measurement of optic nerve sheath diameter for diagnosis of increased intracranial pressure. METHODS: Children between the ages of 0 and 18 years with suspected increased intracranial pressure were prospectively recruited from the emergency department and ICU of an urban, ...
Anile C - - 2009
OBJECTIVE: In this paper, we re-propose the role of a hydraulic mechanism, acting where the bridging veins enter the dural sinuses in cerebral blood flow (CBF) autoregulation. MATERIALS AND METHODS: We carried out an intraventricular infusion in ten albino rabbits and increased intracranial pressure (ICP) up to arterial blood pressure ...
Al-Tamimi Yahia Z - - 2009
OBJECTIVE: Intraparenchymal monitoring devices play an important role in the daily management of head injury and other critically ill neurosurgical patients. Although zero drift data exist for the Camino system (Camino Laboratories, San Diego, CA), only in vitro data exist for the Codman system (Codman and Shurtleff, Inc., Raynham, MA). ...
Chang Jason J J - - 2009
OBJECTIVE: Assess the prevalence of brain tissue hypoxia in patients with severe traumatic brain injuries (TBI), and to characterize the relationship between brain tissue hypoxia and functional outcome. DESIGN: Retrospective review of severe TBI patients. SETTING: Intensive care unit of a level I trauma center. PATIENTS: Twenty-seven patients with severe ...
Montiel Virginie - - 2009
Intraventricular hemorrhage during pregnancy is usually followed by a poor recovery. When caused by moyamoya disease, ischemic or hemorrhagic episodes may complicate the management of high intracranial pressure. A 26-year-old Caucasian woman presented with generalized seizures and a Glasgow Coma Score (GCS) of 3 during the 36th week of pregnancy. ...
Ryska M - - 2009
BACKGROUND: The aim of the study was to determine the influence of fractionated plasma separation and absorption (FPSA) on intracranial pressure (ICP) in acute liver failure (ALF). METHODS: A surgical model of ALF in pigs (35-40 kg) was used. We compared laboratory data and haemodynamic parameters from the ALF control ...
Lehrer Joel F - - 2009
Transcranial cerebral sonography (TCCS) is a noninvasive technique that allows the clinician to detect abnormal intracranial-inner-ear fluid interactions in terms of nanoliter tympanic membrane displacements. The displacements recorded in TCCS are evoked either by the acoustic stapedius reflex or spontaneous movements generated by intracranial cardiovascular or by respiratory pressure waves ...
Ono Koichi - - 2009
The present study was designed to examine effects of different mean airway pressure (MAP) settings during high-frequency oscillation (HFO) on oxygenation and inflammatory responses to acute lung injury (ALI) in rabbits. Anesthetized rabbits were mechanically ventilated with a conventional mechanical ventilation (CMV) mode (tidal volume 6 ml/kg, inspired oxygen fraction ...
Ziai Wendy C - - 2009
Elevated intracranial pressure (ICP) is an important marker of neurological deterioration. The occurrence and significance of elevated ICP and low cerebral perfusion pressure (CPP) in aggressively treated spontaneous intraventricular hemorrhage (IVH) are not defined. We performed a secondary longitudinal exploratory data analysis of a randomized multicenter trial of urokinase (UK) ...
Radolovich Danila K DK Academic Neurosurgical Unit, Department of Clinical Neuroscience, University of Cambridge, Addenbrooke's Hospital, P.O. Box 167, Cambridge, CB2 2QQ, UK. - - 2009
It has been reported recently that correlation between brain tissue oxygen (PbtO2) and cerebral perfusion pressure (CPP) may serve as an indicator of cerebral autoregulation after subarachnoid hemorrhage. We aimed to compare similar indices describing interaction between changes in intracranial pressure (ICP), arterial blood pressure (ABP), and brain tissue oxygen ...
Calisto A A Department of Matter Physics and Electronic Engineering, University of Messina, Italy. - - 2009
The objective of this study is to investigate Id-iopatic Normal Pressure Hydrocephalus (INPH) through a multidimensional and multiparameter analysis of statistical data obtained from accurate analysis of Intracranial Pressure (ICP) recordings. Such a study could permit to detect new factors, correlated with therapeutic response, which are able to validate a ...
Hamilton Robert R Neural Systems and Dynamics Laboratory, Department of Neurosurgery, University of California, Los Angeles, CA, USA. - - 2009
Management of intracranial pressure (ICP) following a traumatic brain injury (TBI) is an essential aspect of minimizing such secondary brain injuries as intracranial hypertension and cerebral hypoxia. Currently, ICU management of ICP elevations is reactive in nature; we propose a quantitative method to predict potentially harmful elevations in ICP. Continuous ...
Fagenholz Peter J - - 2009
Increased intracranial pressure is suspected in the pathogenesis of acute mountain sickness (AMS), but no studies have correlated it with the presence or severity of AMS. We sought to determine whether increased optic nerve sheath diameter, a surrogate measure of intracranial pressure, is associated with the presence and severity of ...
Ramakrishna Rohan - - 2008
OBJECT: Poor outcome is common after aneurysmal subarachnoid hemorrhage (SAH). Clinical studies suggest that cerebral hypoxia after traumatic brain injury is associated with poor outcome. In this study we examined the relationship between brain oxygen tension (PbtO(2)) and death after aneurysmal SAH. METHODS: Forty-six patients, including 34 women and 12 ...
Elf Kristin - - 2008
OBJECTIVES: To describe the occurrence of spontaneous hyper- and hypothermia in patients with traumatic brain injury using a computerized data collecting system, to show how temperature correlates with other secondary insults, to describe how temperature affects outcome and to show how barbiturate treatment influences those analyses. METHODS: Patients with > ...
Stewart Jonathan T - - 2008
Intracranial space-occupying lesions are felt to be a relative contraindication to electroconvulsive therapy (ECT), although there have been several reports of safely treating patients with a variety of intracranial vascular malformations. We report a patient with a parietal cavernous hemangioma (CH), whose ECT proceeded without incident. We elected to mitigate ...
Giannessi Massimo - - 2008
BACKGROUND: We developed a comprehensive cerebral blood flow and intracranial pressure model to simulate and study the complex interactions in cerebrovascular dynamics caused by multiple simultaneous alterations, including normal and abnormal functional states of autoregulation of the brain. METHODS: Individual published equations (derived from prior animal and human studies) were ...
Kocaeli Hasan - - 2008
BACKGROUND: We aimed to investigate intracranial pressure (ICP) changes during early versus late bedside percutaneous tracheostomy (PT) in a neuro-intensive care unit (NICU). METHODS: This study included 30 patients admitted to our NICU for head trauma, subarachnoid haemorrhage, intracerebral haematoma or brain tumour with a Glasgow Coma Score (GCS) less ...
Bershad Eric M - - 2008
Intracranial hypertension implies profoundly disturbed intracranial physiology. Although a shared manifestation of myriad neurological disorders of patients admitted in the intensive care unit (ICU), the pathways leading to intracranial hypertension vary by etiology. Acute elevation of the intracranial pressure is an emergency and may rapidly lead to brain death or ...
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