A New Miniaturized System for Monitoring the Epidural Pressure in Children and Adults

Dietrich, K.; Gaab, M. R.; Oe, Knoblich; Schupp, Joachim; B, Ott

doi:10.1055/s-0028-1091501

Cited by 23 publications

(2 citation statements)

References 8 publications

(11 reference statements)

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“…Furthermore, conventional therapy for the individual underlying brain damage, such as corticosteroid treatment, application of osmotic agents, control of blood pressure, and infusion of adequate amounts of cristalline and colloid fluids, was applied. 16 In all patients, ICP was measured with an epidural device 17 (Gaeltec Ltd., Dunvegan, Isle of Skye, Scotland). Arterial blood pressure was measured with a radial pressure transducer, and Paco 2 , Pao 2 , and pH were monitored by blood gas analysis.…”

Section: Methodsmentioning

confidence: 99%

Doppler CO2 test as an indicator of cerebral vasoreactivity and prognosis in severe intracranial hemorrhages.

Klingelhöfer

Sander

1992

Stroke

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Background and Purpose: Transcranial Doppler ultrasonography is a noninvasive, reproducible technique that allows the assessment of CO 2 -induced cerebral vasomotor reactivity. We investigated the effect of CO 2 changes on cerebral blood flow velocity in patients with severe intracranial hemorrhage and evaluated the relation between CO 2 reactivity, intracranial pressure, and outcome.Methods: Transcranial Doppler parameters, intracranial pressure, arterial blood pressure, and Paco 2 were measured simultaneously in 40 patients. To determine CO 2 reactivity, the initial PaCO 2 of each patient was lowered by at least 6 mm Hg by controlled hyperventilation. Relative CO 2 reactivity was defined as the percent change in mean flow velocity per mm Hg PaCO 2 (averaged during 20 heart cycles before and after approximately 15 minutes of increased hyperventilation).Results: A significantly reduced relative CO 2 reactivity was observed in the patient group compared with a healthy, age-matched control group. Relative CO 2 reactivity was maintained significantly better in patients with moderate intracranial pressure than in patients with markedly increased intracranial pressure. An indirect correlation was found between intracranial pressure and relative CO 2 reactivity (r=-0.89; p<0.001). Clinical outcome was significantly related to the initial relative CO 2 reactivity. Whereas the patients with good recovery had shown a largely preserved reactivity (mean±SD, 3.4 ±0.7%) that did not differ significantly from the control group, there was a continuous decrease up to the patients who died (0.8 ±0.3%).Conclusions: Transcranial Doppler CO 2 testing in patients with severe cerebral disease and elevated intracranial pressure provides useful information regarding hemodynamic state, prognosis, and determination of beneficial effects of specific therapy. (Stroke 1992;23:962-966) KEY WORDS • carbon dioxide • cerebral hemorrhage • stroke outcome • ultrasonics

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Section: Methodsmentioning

confidence: 99%

Doppler CO2 test as an indicator of cerebral vasoreactivity and prognosis in severe intracranial hemorrhages.

Klingelhöfer

Sander

1992

Stroke

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“…The left (LEP) and right (REP) epidural pressures were recorded parietally with special minia ture force transducers [4], The fronto-occipital bipolar EEG was recorded bilaterally by using silver screws. The EEG was evaluated continuously with a computer by FastFourier analysis [power spectra; 18], The power densities were calculated as total ( I -25 Hz), (8-(l-3.5 Hz), -8--(4-7.5 Hz) and a-(8-13.5 Hz) power1, and were separately drawn linearly in arbitrary units over the same time abscissa as the ICP.…”

Section: Methodsmentioning

confidence: 99%

Comparison of the Effects of Surgical Decompression and Resection of Local Edema in the Therapy of Experimental Brain Trauma

Gaab¹,

Knoblich²,

Fuhrmeister³

et al. 1979

Pediatr Neurosurg

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The effect of decompressive trepanation was compared to that of surgical resection of the traumatized tissue in the course of traumatic brain edema in standardized experimental brain trauma. Following a right parietal cold injury, the following parameters were monitored continuously in 12 cats: ventricular pressure, epidural pressure over both hemispheres, arterial and central venous pressure and heart rate. The EEG was evaluated continuously, using a computer (power spectra). After catheterization of the superior sagittal sinus, cerebral arteriovenous differences of glucose, lactate, O₂ and CO₂ were calculated. 6 animals were treated surgically when showing elevated intracranial pressure ICP and markedly altered EEG. In 3 animals, the right hemisphere was decompressed by extensive resection of bone and dura. In 3 further animals, the softened brain tissue of the cold lesion was resected and the skull defect closed. 6 untreated animals were used as controls.A decompression by skull hemiresection for ablation of the injured cortex abolished the high intracranial pressure, but only the latter method seemed to prevent further damage. This could be demonstrated by the EEG registration, and by the normalization of arteriovenous metabolite differences. Only animals treated with edema resection had a normal arousal reaction and survived the trauma. The results indicate, that only an ablation of the local injury will prevent further damage to the brain. After decompressive trepanation alone, the progression of tissue edema is not interrupted. As can be seen from the literature, the poor results obtained even from extensive decompressive operations in traumatic brain edema, indicate that the further development of edema is independent of the intracranial pressure, whereas the Comparison of the Effects of Surgical Decompression and Resection of Edema 485 favorable results of resection of lobar contusions show an interruption of the spread of dysbolism.

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Therapy of Experimental Brain Edema in Cats

Gaab¹,

Knoblich²,

Dietrich³

et al. 1977

Advances in Neurosurgery

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A New Miniaturized System for Monitoring the Epidural Pressure in Children and Adults

Cited by 23 publications

References 8 publications

Doppler CO2 test as an indicator of cerebral vasoreactivity and prognosis in severe intracranial hemorrhages.

Doppler CO2 test as an indicator of cerebral vasoreactivity and prognosis in severe intracranial hemorrhages.

Comparison of the Effects of Surgical Decompression and Resection of Local Edema in the Therapy of Experimental Brain Trauma

Therapy of Experimental Brain Edema in Cats

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