Document Detail

Bilateral ICP monitoring: its importance in detecting the severity of secondary insults.
MedLine Citation:
PMID:  9779139     Owner:  NLM     Status:  MEDLINE    
The aim of head injury management is to prevent secondary insults to the damaged brain. Raised intracranial pressure and low cerebral perfusion pressure are two secondary insults which are important determinants of outcome following severe head injury (SHI). Traditionally ICP is measured in the right frontal region in an attempt to minimise the effects and complications of transducer placement. This assumes that the brain acts like a fluid and that ICP is transmitted equally throughout the intracranial space. Experimental studies suggest that this is not the case: expanding mass lesions are associated with the development of ICP gradients. Ten patients with SHI who had an unilateral mass lesion confirmed on CT were studied. All had bilateral placement of intraparenchymal Camino ICP transducers in the frontal regions. Data from both transducers were recorded every two minutes and stored electronically. The volume of the mass lesion was calculated from the CT scan. Significant and lasting ICP gradients between hemispheres were found in all patients with an acute subdural haematoma (greater than 10 mmHg for longer than 10 minutes). Such differences were not found in patients with intracerebral haematoma or contusions. We would advocate that ICP is recorded IPSILATERAL to the lesion in patients with SHI due to acute subdural haematoma.
I R Chambers; P J Kane; D F Signorini; A Jenkins; A D Mendelow
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta neurochirurgica. Supplement     Volume:  71     ISSN:  0065-1419     ISO Abbreviation:  Acta Neurochir. Suppl.     Publication Date:  1998  
Date Detail:
Created Date:  1999-01-14     Completed Date:  1999-01-14     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  100962752     Medline TA:  Acta Neurochir Suppl     Country:  AUSTRIA    
Other Details:
Languages:  eng     Pagination:  42-3     Citation Subset:  IM    
Regional Medical Physics Department, Newcastle General Hospital, Newcastle-upon-Tyne, U.K.
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MeSH Terms
Blood Pressure / physiology
Dominance, Cerebral / physiology*
Frontal Lobe / blood supply
Hematoma, Subdural / diagnosis*,  physiopathology
Intracranial Hypertension / diagnosis*,  physiopathology
Intracranial Pressure / physiology*
Monitoring, Physiologic
Signal Processing, Computer-Assisted
Tomography, X-Ray Computed

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