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Vandevord Pamela J - - 2008
Gurdjian et al. proposed decades ago that pressure gradients played a major factor in neuronal injury due to impact. In the late 1950s, their experiments on concussion demonstrated that the principal factor in the production of concussion in animals was the sudden increase of intracranial pressure accompanying head injury. They ...
Mitchell G - - 2008
Loss of consciousness caused by positional changes of the head results from reduced cerebral blood flow (CBF). CBF is related to cerebral perfusion pressure (CPP). CPP is the difference between mean arterial pressure (MAP) at the head and intracranial pressure (ICP). The positional change of the giraffe head between ground ...
Olzowy Bernhard - - 2008
The levels of distortion product otoacoustic emissions (DPOAEs) change at frequencies between 0.75 and 1.5 kHz along with intracranial pressure (ICP) and DPOAEs are suggested for monitoring ICP changes. Elevated ICP plays a major role in high-altitude disease, but direct measurement is unlikely to be feasible at high altitudes. The ...
Sutherland A I - - 2008
OBJECTIVE: To investigate the association of optic nerve sheath diameter (ONSD), as a correlate of intracranial pressure (ICP), with acute mountain sickness (AMS). DESIGN: Longitudinal cohort study of mountaineers from sea level to 6400 m. SETTING: Mount Everest (North side). PARTICIPANTS: 13 mountaineers (10 men, 3 women; aged 23-52 years) ...
Wan Wei Hwang - - 2008
Despite a century of work on the subject, controversy still exists as to the physiological relevance of the Cushing response (CR), a state of raised systemic blood pressure and bradycardia associated with raised intracranial pressure. The alternative that has been proposed to the classical belief of pre-terminal brainstem damage is ...
Shahsavari Sima - - 2008
Considering cardiorespiratory interaction and heart rate variability, a new approach is proposed to decompose intracranial pressure and arterial blood pressure to their different harmonics. The method is based on tracking the amplitudes of the harmonics by a Kalman filter based tracking algorithm. The algorithm takes benefit of combined frequency estimation ...
Wendon Julia - - 2008
Cerebral edema is a potential life-threatening complication in patients with acute liver failure who progress to grade III/IV encephalopathy. The incidence is variably reported but appears to be most prevalent in those patients with hyperacute liver failure as opposed to subacute forms of liver failure. In those patients who are ...
Lin J W - - 2008
Traumatic brain injury (TBI) is a major cause of death and disability. In the 2000 guidelines, one of the suggestions for TBI treatment was to maintain cerebral perfusion pressure (CPP) < or = 70 mmHg. But in the 2003 guidelines, the suggestion was changed to < or = 60 mmHg. ...
Gao Chun Ping - - 2008
BACKGROUND: Decompressive craniectomy is the final phase in the graded scheme of critical care management of refractory raised intracranial pressure following severe traumatic brain injury. We aim to define the optimal size for decompressive craniectomy so that a good balance is achieved between reduction of raised ICP and the extent ...
Beattie Zachary T - - 2008
Pressure beat detection is an integral part of most analysis techniques for arterial blood pressure (ABP), intracranial pressure (ICP), and pulse oximetry (SpO(2)) signals. Beat detection has been used to estimate heart rate in the ABP signal, to classify ICP morphologies, and to estimate blood pressure using pulse oximeter waveforms. ...
Hu Xiao - - 2008
BACKGROUND: Potentially useful information may exist in the morphological changes in intracranial pressure pulse therefore their extraction by automated methods is highly desirable. METHODS: Long-term continuous recordings of intracranial pressure and electrocardiogram (ECG) signals were analyzed for four patients undergoing intracranial pressure (ICP) monitoring with their implanted shunts externalized and ...
Vink Robert - - 2008
BACKGROUND: While it is understood that raised intracranial pressure (ICP) after traumatic brain injury (TBI) may negatively impact on brain tissue oxygenation (PbtO2), few studies have characterized the inter-relationship between these two variables, particularly in a large animal model that replicates the human gyrencephalic brain. The current study uses an ...
Bilotta Federico - - 2008
INTRODUCTION: In patients with severe head trauma, endotracheal suctioning can result in adverse reactions including cough, systemic hypertension, increased intracranial pressure, and reduced cerebral perfusion pressure. The aim of this prospective, blinded clinical trial in mechanically ventilated patients with severe head trauma whose cough reflexes were still intact was to ...
Pfister D - - 2008
INTRODUCTION: In sepsis the brain is frequently affected although there is no infection of the CNS (septic encephalopathy). One possible cause of septic encephalopathy is failure of the blood-brain barrier. Brain edema has been documented in animal models of sepsis. Aggressive fluid resuscitation in the early course of sepsis improves ...
Naidech Andrew M - - 2008
INTRODUCTION: Vasospasm is a major cause of morbidity after subarachnoid hemorrhage (SAH), and current screening techniques (angiography, transcranial Doppler [TCD], and clinical examination) have serious limitations. Brain oximetry is a promising noninvasive tool to detect reduced brain oxygenation from vasospasm. METHODS: Consecutive SAH patients at high risk for vasospasm were ...
Shahsavari Sima - - 2008
BACKGROUND: The transfer functions which map the arterial blood pressure to the intracranial pressure and the compensatory reserve index have been investigated by various groups to evaluate the brain compliance of patients with traumatic brain injury. The focus of this study has been to assess the capability of both the ...
Bjerring Peter Nissen - - 2008
AIM: Hyperammonemia causes brain edema and high intracranial pressure (ICP) in acute liver failure (ALF) by accumulation of glutamine in brain. Since a high-level glutamine may compromise mitochondrial function, the aim of this study was to determine if the lactate-pyruvate ratio is associated with a rise in the glutamine concentration ...
Minns R A - - 2008
BACKGROUND: Useful information (both clinical and pathophysiological) which may be extracted from intracranial pressure (ICP) recordings include: (1) the mean level of ICP (and CPP), (2) cerebrovascular autoregulation status, (3) the intracranial pulse pressure (the pulse wave index, ICPpp/ICPm) or the pressure-volume compensatory reserve index (RAP) and (4) the presence ...
Vargiami Euthymia - - 2008
We report on an 8-year-old girl with hemolytic anemia because of infection with parvovirus B19 and increased intracranial pressure. She presented acutely with headache, vomiting, and mild scleral and mucosal icterus. Upon evaluation, the patient exhibited profound hemolytic anemia, papilledema, and increased intracranial pressure. The patient was treated with intravenous ...
Jones P A - - 2008
BACKGROUND: Secondary pathophysiological CPP insult is related to outcome after head injury, and improved management would be expected to reduce secondary brain insult. Paediatric head injury management guidelines have been published in recent years, by SIGN (2000), RCPCH (2001), NICE (June 2003), and jointly by Critical/Intensive Care Societies (C/ICS July ...
Meier Regula - - 2008
INTRODUCTION: Hyperglycaemia is detrimental, but maintaining low blood glucose levels within tight limits is controversial in patients with severe traumatic brain injury, because decreased blood glucose levels can induce and aggravate underlying brain injury. METHODS: In 228 propensity matched patients (age, sex and injury severity) treated in our intensive care ...
Talbert David G - - 2008
It is hypothesised that the inflammatory condition seen in MS and the progressive myelopathy that is being successfully halted by obliteration of dural arteriovenous fistulas (DAVFs), may actually be two sides of the same coin. Excessive venous hypertension can stretch vein walls sufficiently to separate the tight junctions between endothelial ...
Tanne Emanuel - - 2008
This report highlights a conference designed for patient education on elevated cerebrospinal fluid (CSF) pressure. The conference centered on chronic intracranial hypertension (IH) including the latest research and clinical information. It was sponsored by the Intracranial Hypertension Research Foundation and held at the University of Texas Medical School, Houston, on ...
Geeraerts Thomas - - 2008
Invasive devices are recommended for the early detection of raised intracranial pressure (ICP) after severe traumatic brain injury. Owing to contraindication or local issues, however, invasive ICP monitoring is not always possible. Moreover, a significant proportion of moderate traumatic brain injury patients (managed without invasive ICP) will develop raised ICP. ...
Cremer O L - - 2008
Raised intracranial pressure and low cerebral perfusion pressure are associated with ischaemia and poor outcome after brain injury. Therefore, many management protocols target these variables. However, there are no randomized controlled trials that have demonstrated the effectiveness of intracranial pressure-guided care in severely head-injured patients. Observational studies of such therapy ...
Rehman Tausif - - 2008
We report a case of mild to moderate traumatic brain injury in which ICP monitoring or quantitative cerebral perfusion data may have allowed earlier recognition of impending herniation, avoidance of a secondary insult, and ultimately resulted in a better outcome, even though the patient did not meet the standard guidelines ...
Lim Min Hee - - 2008
We report an adult end-stage renal disease patient with only cerebellum involvement of reversible posterior leukoencephalopathy syndrome (RPLS). A 37-year-old woman, diagnosed as chronic glomerulonephritis, was admitted to our hospital with progressive visual disturbance and severe headache. MRI revealed hyperintense signal intensity changes restricted in the cortex and subcortical white ...
Sithinamsuwan Pasiri - - 2008
We compared cerebrospinal fluid (CSF) opening pressure measurements in the lumbar subarachnoid space between the flexed position (F-OP) and relaxed position (R-OP) in recumbent patients. We devised an equation for using F-OP to determine the existence of raised intracranial pressure (ICP). Patients (n = 83) underwent lumbar puncture while in ...
Pérez-Bárcena Jon - - 2008
Experimental research has demonstrated that the level of neuroprotection conferred by the various barbiturates is not equal. Until now no controlled studies have been conducted to compare their effectiveness, even though the Brain Trauma Foundation Guidelines recommend that such studies be undertaken. The objectives of the present study were to ...
Smith Martin M National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust, London, UK. - - 2008
Increased intracranial pressure (ICP) is an important cause of secondary brain injury, and ICP monitoring has become an established component of brain monitoring after traumatic brain injury. ICP cannot be reliably estimated from any specific clinical feature or computed tomography finding and must actually be measured. Different methods of monitoring ...
Timofeev Ivan I Academic Neurosurgery Unit, University of Cambridge/Addenbrooke's Hospital, Cambridge, United Kingdom. - - 2008
Decompressive craniectomy is an advanced treatment option for intracranial pressure (ICP) control in patients with traumatic brain injury. The purpose of this study was to evaluate the effect of decompressive craniectomy on ICP and cerebrospinal compensation both within and beyond the first 24 hours of craniectomy. This study was a ...
Schuhmann Martin U MU Department of Pediatric Neurosurgery, Children's Hospital of Michigan, Wayne State University School of Medicine, Detroit, Mich., USA. - - 2008
Exaggerated nocturnal intracranial pressure (ICP) dynamics are commonly observed in hydrocephalic children with a compromise of CSF compensatory reserve capacity. Successful shunting restores this cerebrospinal reserve. We used ICP overnight monitoring combined with positional maneuvers in complex hydrocephalic children with a suspected shunt malfunction for the assessment of shunt function. ...
Smielewski P P Neurosurgery Unit, Department of Clinical Neurosciences, University of Cambridge, Addenbrookes Hospital, Level 4, A Block, Cambridge CB0 2QQ, UK. - - 2008
ICM+ software encapsulates 20 years of our experience in brain monitoring gained in multiple neurosurgical and intensive care centres. It collects data from a variety of bedside monitors and produces on-line time trends of parameters defined using configurable signal processing formulas. The resulting data can be displayed in a variety ...
Schmidt B B Department of Neurology, Medical Centre Chemnitz, Dresdner Str. 178, 09131 Chemnitz, Germany. - - 2008
In a formerly introduced mathematical model, intracranial pressure (ICP) could be non-invasively assessed using cerebral blood flow velocity (FV) and arterial blood pressure (ABP). The current study attempts to check whether the accuracy of the non-invasive ICP assessment (nICP) improves after an initial individual calibration by implanted ICP probes. Thirteen ...
Belfort Michael M - - 2008
To determine the cerebral hemodynamic effect of magnesium sulfate (MgSO4) in preeclampsia. Prospective observational study. Tertiary Care Medical Center. Preeclamptic patients (systolic < 160, diastolic < 110 mmHg). Transcranial Doppler (TCD) of the middle cerebral arteries (MCA) of 15 preeclamptics, before and after IV MgSO4. No vasoactive drugs other than ...
Jantzen Jan-Peter A H - - 2007
Intracranial pressure (ICP) is the pressure exerted by cranial contents on the dural envelope. It comprises the partial pressures of brain, blood and cerebrospinal fluid (CSF). Normal intracranial pressure is somewhere below 10 mmHg; it may increase as a result of traumatic brain injury, stroke, neoplasm, Reye's syndrome, hepatic coma, ...
Stevens Scott A - - 2007
OBJECTIVE: To investigate the relationship between idiopathic intracranial hypertension (IIH) and transverse sinus stenosis through experiments performed on a validated mathematical model. METHODS: A mathematical model of intracranial pressure (ICP) dynamics has been extended to accommodate venous sinus compression through the introduction of a Starling-like resistor between the sagittal and ...
Ogasawara Kuniaki - - 2007
OBJECT: Intracranial hemorrhage associated with cerebral hyperperfusion syndrome (CHS) following carotid endarterectomy (CEA) or carotid artery stenting (CAS) is a rare but potentially devastating complication. In the present study the authors evaluated 4494 patients with carotid artery stenosis who had undergone CEA or CAS to clarify the clinicopathological features and ...
Tommasino Concezione - - 2007
Osmolality is the primary determinant of water movement across the intact blood-brain barrier (BBB), and we can predict that reducing serum osmolality would increase cerebral oedema and intracranial pressure. Brain injury affects the integrity of the BBB to varying degrees. With a complete breakdown of the BBB, there will be ...
Vespa Paul M - - 2007
OBJECTIVE: To determine whether nonconvulsive electrographic post-traumatic seizures result in increases in intracranial pressure and microdialysis lactate/pyruvate ratio. DESIGN: Prospective monitoring with retrospective data analysis. SETTING: Single center academic neurologic intensive care unit. PATIENTS: Twenty moderate to severe traumatic brain injury patients (Glasgow Coma Score 3-13). MEASUREMENTS AND MAIN RESULTS: ...
Eide P K - - 2007
OBJECTIVE: To investigate the association among intracranial compliance (ICC), intracranial pulse pressure amplitude and intracranial pressure (ICP) in patients with intracranial bleeds. METHODS: Five patients with intracranial bleeds had their ICC and ICP monitored during days 1-8 after ictus. The recordings were stored as raw data files and analysed retrospectively. ...
Fàbregas Neus - - 2007
Recovery from general anaesthesia is a period of intense stress for patients: there is sympathetic activation, catecholamine release, and increase in blood pressure or heart rate. Stressful events increase cerebral blood flow and cerebral oxygen consumption, potentially producing elevation of intracranial pressure and thus, favouring cerebral insults. Measures to prevent ...
Rose Christopher C Department of Cellular Neuroscience, Max-Delbrück Center for Molecular Medicine, Berlin, - - 2007
We previously demonstrated in pigs with acute liver failure (ALF) that albumin dialysis using the molecular adsorbents recirculating system (MARS) attenuated a rise in intracranial pressure (ICP). This was independent of changes in arterial ammonia, cerebral blood flow and inflammation, allowing alternative hypotheses to be tested. The aims of the ...
Thorat J D - - 2008
The aim of this study was to explore the effects of barbiturate coma on cerebral tissue oxygen tension and cerebrovascular pressure reactivity (PRx), as an index of cerebral autoregulation in severe head injury patients. This was a prospective observational clinical study of 12 patients with severe traumatic brain injury, carried ...
Yao Y - - 2007
The use of decompressive craniectomy for massive cerebral infarction is attracting renewed interest because conventional medical treatment is associated with high mortality. The technique of duraplasty may be important. We have developed a 4 step volume-enlarged cruciate duraplasty and report its use in 12 patients with massive cerebral infarction. None ...
Cole Chad D - - 2007
OBJECTIVE: Although volatile anesthetics have been widely accepted in anesthetic management for neurosurgery, they reduce vascular resistance, resulting in increased cerebral blood flow and increased intracranial pressure (ICP). In patients with elevated ICP who undergo craniotomy, the increase in ICP during surgery from inhaled anesthetics can make the surgery more ...
Vinecore Kevin - - 2007
OBJECTIVE: To describe and report the reliability of a portable, laptop-based, real-time, continuous physiologic data acquisition system (PDAS) that allows for synchronous recording of physiologic data, clinical events, and event markers at the bedside for physiologic research studies in the intensive care unit. DESIGN: Descriptive report of new research technology. ...
Limperopoulos Catherine - - 2007
OBJECTIVE: Hypotension is a commonly treated complication of prematurity, although definitions and management guidelines vary widely. Our goal was to examine the relationship between current definitions of hypotension and early abnormal cranial ultrasound findings. METHODS: We prospectively measured mean arterial pressure in 84 infants who were < or = 30 ...
Vespa Paul M - - 2007
OBJECTIVE:: To determine whether nonconvulsive electrographic post-traumatic seizures result in increases in intracranial pressure and microdialysis lactate/pyruvate ratio. DESIGN:: Prospective monitoring with retrospective data analysis. SETTING:: Single center academic neurologic intensive care unit. PATIENTS:: Twenty moderate to severe traumatic brain injury patients (Glasgow Coma Score 3-13). MEASUREMENTS AND MAIN RESULTS:: ...
Geeraerts Thomas - - 2008
OBJECTIVE: To examine whether the effect of hypoxia-hypotension (HH) after traumatic brain injury (TBI) is affected by the delay between insults. DESIGN: Thirty Sprague-Dawley rats were randomized into five groups: sham, TBI alone (trauma alone, impact-acceleration, 450 g weight drop from 1.8 m), HH alone (blood depletion, mean arterial pressure ...
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