Search Results
Results 401 - 450 of 2459
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Schmittner Marc D - - 2007
In neurosurgical patients, opioids are administered to prevent secondary cerebral damage. Complications often related to the administration of opioids are a decrease in blood pressure affording the use of vasopressors and intestinal atonia. One alternative approach to opioids is the application of S(+)-ketamine. However, owing to a suspected elevation of ...
Himmelseher Sabine - - 2007
PURPOSE OF REVIEW: This review aims to provide an update on recent knowledge gained on hypertonic saline solutions for the treatment of intracranial hypertension. Explanatory approaches to the mechanisms underlying the edema-reducing effects of the solutions are outlined, practical aspects of use are presented, and trials that assessed their clinical ...
Ryttlefors Mats - - 2007
OBJECTIVE: To study the occurrence of secondary insults during neurointensive care of patients with subarachnoid hemorrhage using a computerized multimodality monitoring system and to study the impact of secondary insults on clinical deterioration and functional outcome. METHODS: Patients with subarachnoid hemorrhage who were admitted to the neurointensive care unit between ...
Lakin William D - - 2007
INTRODUCTION: A majority of astronauts experience symptoms of headache, vomiting, nausea, lethargy, and gastric discomfort during the first few hours or days after entering a microgravity environment. Due to similarities in symptoms and their time evolution, it has been hypothesized that some of these conflicts are related to the development ...
Inaba Kenji - - 2007
There are no independent computed tomography (CT) findings predictive of elevated intracranial pressure (ICP). The purpose of this study was to evaluate brain density measurement on CT as a predictor of elevated ICP or decreased cerebral perfusion pressure (CPP). A prospectively collected database of patients with acute traumatic brain injury ...
Smith Michael Louis - - 2007
OBJECTIVES: Brain death is a clinical diagnosis often confirmed with supplementary tests. In this study, we examined the relationship between brain death and the partial pressure of brain tissue oxygen (PbtO(2)). We hypothesized that a sustained PbtO(2) of 0 is associated with brain death. METHODS: One hundred and twenty-six patients ...
Hardy Warren N - - 2007
High-speed biplane x-ray and neutral density targets were used to examine brain displacement and deformation during impact. Relative motion, maximum principal strain, maximum shear strain, and intracranial pressure were measured in thirty-five impacts using eight human cadaver head and neck specimens. The effect of a helmet was evaluated. During impact, ...
Czosnyka Marek M Academic Neurosurgery Unit, Department of Neurosciences, University of Cambridge, Box 167, Addenbrooke's Hospital, Cambridge CB2 2QQ, UK. - - 2007
In addition to intracranial pressure (ICP) and cerebral perfusion pressure (CPP), there are many more brain-related measures defined as 'pressures'. Cerebral intra-tissue pressure, critical closing pressure, 'optimal' CPP, non-invasive CPP (nCPP) and non-invasive ICP (nICP), interhemispherical pressure gradients are the modalities which currently attract more attention in the management of ...
Zoremba Norbert - - 2007
BACKGROUND: Cranial hypertension coincides with a reduction in cerebral blood flow as well as in oxygen delivery and influences outcome. In this study, we monitored changes in energy-related metabolites in the porcine cortex during an increase of intracranial pressure (ICP) and to determine the level at which damage occurs. METHODS: ...
Griebenow Martin - - 2007
Recent data suggest that ubiquitin has anti-inflammatory properties and therapeutic potential after severe trauma and brain injuries. However, direct evidence for its neuroprotective effects has not yet been provided. We hypothesized that ubiquitin treatment is neuroprotective, and thus reduces brain edema formation and cortical contusion volume after closed traumatic brain ...
Torres Rayne Borges - - 2007
INTRODUCTION: The concentration of 2,3-diphosphoglycerate (2,3-DPG/Hct) increases as a physiological occurrence to pH increase and hyperventilation. This response was tested in patients with severe traumatic brain injury (TBI). METHOD: The concentration of 2,3-DPG/Hct was measured daily for six days in eleven patients with severe TBI in need of optimized hyperventilation ...
Longhi Luca - - 2007
OBJECTIVE: We compared brain tissue oxygen tension (PtiO2) measured in peri-focal and in normal-appearing brain parenchyma on computerized tomography (CT) in patients following traumatic brain injury (TBI). DESIGN: Prospective observational study. SETTING: Neurointensive care unit. PATIENTS AND PARTICIPANTS: Thirty-two consecutive TBI patients were subjected to PtiO2 monitoring. INTERVENTIONS: Peri-focal tissue ...
Kofke W Andrew - - 2007
There are numerous clinical scenarios wherein a critically ill patient may present with neurologic dysfunction. In a general sense these scenarios often involve ischemia, trauma, or neuroexcitation. Each of these may include a period of decreased cerebral perfusion pressure, usually due to elevated intracranial pressure (ICP), eventually compromising cerebral blood ...
Eide P K PK Department of Neurosurgery, The National Hospital (Rikshospitalet), Oslo, Norway. - - 2007
To explore whether intracranial pulse pressure amplitudes relate to arterial pulse pressure amplitudes and whether correlations between time-related changes in intracranial and arterial pulse pressure amplitudes associate with indices of cerebral autoregulation. A total of 257 continuous and simultaneous intracranial pressure (ICP), arterial blood pressure (ABP) and middle cerebral artery ...
Brady Ken M KM Johns Hopkins University School of Medicine, Department of Anesthesiology, Division of Pediatric Anesthesiology and Critical Care Medicine, 600 North Wolfe Street, Blalock 904, Baltimore, MD 21287, USA. - - 2007
Assessment of autoregulation in the time domain is a promising monitoring method for actively optimizating cerebral perfusion pressure (CPP) in critically ill patients. The ability to detect loss of autoregulatory vasoreactivity to spontaneous fluctuations in CPP was tested with a new time-domain method that used near-infrared spectroscopic measurements of tissue ...
Carter B G - - 2008
OBJECTIVE: To determine the predictive powers of intracranial pressure (ICP) and cerebral perfusion pressure (CPP) amongst severely brain injured children. MATERIALS AND METHODS: ICP and CPP were recorded from thirty-five severely brain injured children who were prospectively recruited after admission to paediatric intensive care. Twenty-five suffered traumatic brain injury (TBI) ...
Eide P K - - 2007
This report addresses whether intracranial pulse pressure amplitudes are associated with brain energy metabolism, examined by intracerebral microdialysis. We present a 65-year-old female with an aneurysmal subarachnoid haemorrhage (SAH) from a left posterior communicating artery (PCOM) aneurysm. She underwent simultaneous intracranial pressure (ICP) monitoring and microdialysis (MD) as part of ...
Stocchetti Nino - - 2007
High intracranial pressure (HICP) may be a very early event after traumatic brain injury (TBI), but in most cases, especially when contusions and edema develop over time, HICP will worsen over succeeding days. This study describes the incidence and severity of elevated intracranial pressure (ICP) after TBI and attempts to ...
Heegaard William - - 2007
Traumatic brain injury (TBI) is a significant source of morbidity and mortality throughout the world. This article discusses the epidemiology, pathophysiology, and clinical presentations of minor, moderate, and severe TBI. Controversial topics, such as hypertonic saline for increased intracranial pressure, prehospital intubation of patients who have experienced TBI, and the ...
Brackmann Derald E - - 2007
OBJECTIVE: Describe neurotologic findings associated with idiopathic intracranial hypertension (IIH). STUDY DESIGN: Retrospective. SETTING: Tertiary referral center. PATIENTS: Case of IIH (>250 mm water) presenting with unilateral facial palsy and enlargement of the fallopian canal on computed tomography and magnetic resonance imaging. INTERVENTION(S): Oral acetazolamide, corticosteroids, and cerebrospinal fluid drainage. ...
Hu Xiao - - 2007
Causal coherence and generalized synchronization (GS) index were extracted from beat-to-beat mean intracranial pressure (ICP) and intervals between consecutive normal sinus heart beats (RR interval) that were recorded from 12 patients undergoing normal pressure hydrocephalus diagnosis. Data were organized into two groups including an ICP B-Wave group and a baseline ...
Oertel Matthias F - - 2007
After subarachnoid hemorrhage (SAH) cerebral metabolism is significantly impaired. Hyperglycolysis describes the reduction of oxidative metabolism followed by a relative increase of anaerobic glycolysis to maintain energy supply. This phenomenon is known in head injury but has not as yet been shown after SAH. This study was conducted to test ...
Miller Marijean - - 2007
Elevation and blur of the optic disc margin with hyperemia and flame hemorrhages are classic features of papilledema that may not be present with mild elevations of the cerebral spinal fluid pressure. In children, the disc can be dramatically elevated with indistinct margins in pseudopapilledema. Children with equivocal disc features ...
Reinert Michael - - 2007
Determination of relevant clinical monitoring parameters for helping guide the intensive care therapy in patients with severe head injury, is one of the most demanding issues in neurotrauma research. New insights into cerebral autoregulation and metabolism have revealed that a rigid cerebral perfusion pressure (CPP) regimen might not be suitable ...
Kolkert Joe L P - - 2007
Organs used for transplantation are usually derived from heart-beating brain dead donors. However, brain death is known to have negative effects on donor organ quality, previously studied using a difficult to control sudden onset experimental model. We have now developed a reproducible gradual onset brain death model in rats without ...
Shah Qaisar A - - 2007
Non-traumatic or spontaneous intracerebral hemorrhage (ICH) is defined as intra-parenchymal bleeding with or without extension into the ventricles and rarely into the subarachoid space. Primary ICH in most cases is associated with chronic hypertension. Acute hypertension is associated with hematoma expansion, and poor neurological outcome. The treatment of hypertension in ...
Fiordalisi Irma - - 2007
BACKGROUND: During the late 1900s, raised intracranial pressure (ICP) during treatment of pediatric diabetic ketoacidosis (DKA) surfaced as the most important cause of morbidity and mortality in pediatric DKA. The contribution of fluid and electrolyte therapy to neurologic deterioration during treatment remains controversial. METHODS: We proposed a physiologic approach to ...
Priebe H-J - - 2007
The anaesthetist may be involved at various stages in the management of subarachnoid haemorrhage (SAH). Thus, familiarity with epidemiological, pathophysiological, diagnostic, and therapeutic issues is as important as detailed knowledge of the optimal intraoperative anaesthetic management. As the prognosis of SAH remains poor, prompt diagnosis and appropriate treatment are essential, ...
Lewis P M PM Academic Neurosurgical Unit, Addenbrooke's Hospital, Cambridge, - - 2007
Although the inclusion of cerebral perfusion pressure (CPP) is a standard feature in static testing of autoregulation after head injury, controversy surrounds the use of CPP versus arterial blood pressure (ABP) in dynamic tests. The aim of our project was to assess the discrepancies between methods of dynamic autoregulation testing ...
Saqqur Maher - - 2007
Transcranial Doppler has several practical applications in neurocritical care. It has its main application in the diagnosis and monitoring of vasospasm in patients with subarachnoid hemorrhage. In addition, it holds promise for the detection of critical elevations of intracranial pressure. Its ability to measure CO2 reactivity and autoregulation may ultimately ...
Da Silva Arnaldo Neves - - 2007
BACKGROUND: Glucocorticoids are the main drug used to control vasogenic edema in patients with brain tumor. Rapid GC tapering may not only decompensate intracranial pressure, but also unmask SAI, and some symptoms of SAI can be mistakenly attributable to increased intracranial pressure or side effects of chemotherapy and radiation therapy. ...
Soehle M M Department of Anaesthesiology and Intensive Care Medicine, University of Bonn, Bonn, Germany. - - 2007
We examined the predictive value of initial clinical status, mean arterial blood pressure (MABP), intracranial pressure (ICP) and transcranial Doppler (TCD)-derived pulsatility and resistance indices for outcome and quality of life one year following aneurysmal subarachnoid haemorrhage (SAH). Neuromonitoring was performed in 29 patients following clipping or coiling of an ...
Latka M - - 2007
We introduce a wavelet transfer model to relate spontaneous arterial blood pressure (ABP) fluctuations to intracranial pressure (ICP) fluctuations. We employ a complex continuous wavelet transform to develop a consistent mathematical framework capable of parametrizing both cerebral compensatory reserve and cerebrovascular reactivity. The frequency-dependent gain and phase of the wavelet ...
Poca Maria Antonia - - 2007
OBJECT: Epidural pressures have been reported as being systematically higher than ventricular fluid pressures. These discrepancies have been attributed both to the characteristics of the sensor and to the particular anatomy of the epidural space. To determine which of these two possible causes better explains higher epidural readings, the authors ...
Salluh J I F - - 2007
BACKGROUND: Maintaining adequate cerebral perfusion pressure is an essential aspect in the treatment of severe acute brain injury. To accomplish this therapeutic goal vasopressors are usually required. Vasopressin is an important endogenous stress hormone and the infusion of low-dose vasopressin and terlipressin has been used to reverse severe hypotension. CASE ...
Soul Janet S - - 2007
Cerebral blood flow pressure-passivity results when pressure autoregulation is impaired, or overwhelmed, and is thought to underlie cerebrovascular injury in the premature infant. Earlier bedside observations suggested that transient periods of cerebral pressure-passivity occurred in premature infants. However, these transient events cannot be detected reliably by intermittent static measurements of ...
Prabhakar H - - 2007
Not many centres measure intracranial pressure during an endoscopic procedure. However, if the irrigation fluid during endoscopy is not simultaneously drained, then some rise in intracranial pressure can be anticipated. This study was carried out to measure and monitor changes in intracranial pressure during the irrigation phase in a neuroendoscopic ...
Henzler Dietrich - - 2007
OBJECTIVE: Survival of patients with severe traumatic brain injury may be improved by minimizing secondary brain injury. We aimed to identify potentially modifiable contributors to secondary brain injury that may persist and adversely affect patient outcome. DESIGN: Retrospective case control study. Nonsurviving patients with traumatic brain injury were selected and ...
Prabhakar H - - 2007
BACKGROUND: The Valsalva manoeuvre results in an increase in intrathoracic pressure which alters the systemic and cerebral circulations significantly. We decided to record changes in the intracranial pressure and cerebral perfusion pressure resulting from a Valsalva manoeuvre in anaesthetised patients. METHODS: 11 patients of either gender submitted to surgical neuroendoscopic ...
Rohr A - - 2007
Elevated intracranial intravenous pressure seems to be of importance in pseudotumor cerebri syndromes, either as a cause (secondary intracranial hypertension) or as a consequence (idiopathic intracranial hypertension) of increased intracranial pressure. We present 3 case reports in which diagnostic imaging before and after CSF diversion provided evidence that narrowing of ...
Avitsian Rafi - - 2007
Cerebral vasospasm after subarachnoid hemorrhage can decrease cerebral blood flow with the potential for stroke. Induction of Triple-H therapy (hypertension, hypervolemia, and hemodilution) is an accepted medical therapy to decrease the delayed cerebral ischemia related to vasospasm. Recently selective intra-arterial injection of nicardipine during angiography has also been proposed as ...
McDannold Nathan - - 2007
We have developed a method to use low-intensity focused ultrasound pulses combined with an ultrasound contrast agent to produce temporary blood-brain barrier disruption (BBBD). This method could provide a means for the targeted delivery of drugs or imaging agents into the brain. In all our previous work, we used Optison ...
Eide Per Kristian - - 2008
Simultaneous continuous intracranial pressure (ICP) signals from two different ICP sensors (Codman ICP MicroSensor; Johnson & Johnson, Raynham, MA) placed within the brain parenchyma and the epidural space were compared in ten patients with idiopathic normal pressure hydrocephalus (iNPH). Comparisons were made at the single ICP wave level by determining ...
Kaptigau W Matui - - 2007
Traumatic brain injury (TBI) is one of 3 leading causes of deaths in the Surgery Department of Port Moresby General Hospital in the last 30 years despite being responsible for only 5% of admissions. It maims and kills the young. Most of these injuries and deaths can be prevented by ...
Scalea Thomas M - - 2007
OBJECTIVES: Fluid therapy and/or acute lung injury may increase intra-abdominal pressure (IAP) and intrathoracic pressure, thereby increasing intracranial pressure (ICP) after traumatic brain injury (TBI). Further fluid administration to support cerebral perfusion or increasing ventilatory support to treat acute lung injury further increases ICP. This can create a cycle that ...
Daley Michael L - - 2007
Changes in the modes of cerebrovascular pressure transmission during cerebral vasodilation induced by hypercapnic challenge were examined as a means for developing the basis for a bedside method to evaluate regulation of cerebral blood flow. Recordings of arterial blood pressure (ABP) and intracranial pressure (ICP) obtained from a piglet preparation ...
Kaptigau W Matui - - 2007
Continuous appraisal of clinical indices with appropriate tests and their recording as evidence of treatment are conducive for evidence-based management of traumatic brain injury (TBI). Monitoring of various neurological indices and relating them to set parameters of TBI is imperative for gauging ongoing treatment. These parameters include cerebral oxygenation, cerebral ...
Murakami Mamoru - - 2007
A 19-year-old female was admitted to our hospital after severe head injury in a traffic accident. On admission, she had no spontaneous respiration, but did have heart beat with a blood pressure of 100/60 mmHg. Neurological examination demonstrated that the Glasgow Coma Scale score was 3 and her pupils were ...
Ract Catherine - - 2007
OBJECTIVE: To evaluate the usefulness of early transcranial Doppler ultrasound (TCD) goal-directed therapy after severe traumatic brain injury initiated before invasive cerebral monitoring is available. DESIGN: Prospective, observational clinical study. SETTING: Surgical intensive care unit, university hospital. PATIENTS AND PARTICIPANTS: Twenty-four severely brain-injured patients. INTERVENTIONS: All patients had TCD measurements ...
Aly E E - - 2007
Idiopathic intracranial hypertension is a rare syndrome characterised by prolonged elevation of intracranial pressure in the absence of hydrocephalus, intracranial mass lesion or infection, and with increased cerebrospinal fluid pressure but a normal composition. We report a case of uncontrolled idiopathic intracranial hypertension successfully managed using an intrathecal catheter for ...
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