Does Brain Swelling Increase Estimated Specific Gravity?

Degos, Vincent; Pereira, Ana-Rosa; Lescot, Thomas; Sanchez-Peña, Paola; Daoudi, Mounir; Zouaoui, A.; Coriat, Pierre; Puybasset, Louis

doi:10.1007/s12028-008-9131-6

Cited by 5 publications

(5 citation statements)

References 13 publications

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“…Studies performed in murine models of head trauma report a decrease in eSG with a rise in the cerebral water content [17,18]. However, and as in our three different studies [14][15][16], Bullock at al. observed an increased SG with severe TBI in the same proportion [19].…”

Section: Interpretation Of Estimated Specific Gravity Variationssupporting

confidence: 70%

“…To understand the relationship between eSG and brain swelling, we compared eSG values of TBI patients and high grade subarachnoid haemorrhage (SAH) patients with a similar severity of brain swelling. The increase of eSG was only highlighted in the TBI group [15]; it was not observed in the high grade SAH group. In a fourth study, we compared eSG value of the non-contused hemispheric areas before and after an hypertonic saline bolus administration, and we observed an increase of eSG associated with a decrease in the volume, corresponding to a correct permeability of the BBB in these areas [16].…”

Section: Quantative Ct Study Of Non-contused Hemispheric Areasmentioning

confidence: 78%

“…Immune cells' proliferation increase tissue specific gravity and they also correlate with brain injuries severity, exacerbating the oedema and leading to prolonged ICP elevation and to higher treatment intensity. Thus, eSG may reflect the early BBB disruption and consequences specifically associated with TBI [15] and may explain why it is correlated with TBI outcome. Regarding the contused areas, experimental data suggest that BBB remains open for a prolonged period of time after trauma [2,3].…”

Section: Interpretation Of Estimated Specific Gravity Variationsmentioning

confidence: 99%

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Estimated Specific Gravity with Quantitative CT Scan in Traumatic Brain Injury

Degos¹,

Lescot²,

Puybasset³

2011

Computed Tomography - Special Applications

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Section: Interpretation Of Estimated Specific Gravity Variationssupporting

confidence: 70%

Section: Quantative Ct Study Of Non-contused Hemispheric Areasmentioning

confidence: 78%

Section: Interpretation Of Estimated Specific Gravity Variationsmentioning

confidence: 99%

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Estimated Specific Gravity with Quantitative CT Scan in Traumatic Brain Injury

Degos¹,

Lescot²,

Puybasset³

2011

Computed Tomography - Special Applications

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“…This mechanism is of short duration and occurs in about 1/4 of the patients with severe TBI, independently of lesions at magnetic resonance images (MRI), thus remaining sequelae for about 2 weeks. It can also worsen the prognosis ( 138 ) through cerebral herniation ( 139 , 140 ) MRI with apparent diffusion coefficient is used to distinguish between vasogenic and cytotoxic edema in TBI patients. While freely diffusible water at MRI is marker of vasogenic edema, restrict water movement represents cytotoxic edema ( 139 ).…”

Section: Research Agendamentioning

confidence: 99%

Escalate and De-Escalate Therapies for Intracranial Pressure Control in Traumatic Brain Injury

et al. 2020

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Severe traumatic brain injury (TBI) is frequently associated with an elevation of intracranial pressure (ICP), followed by cerebral perfusion pressure (CPP) reduction. Invasive monitoring of ICP is recommended to guide a step-by-step “staircase approach” which aims to normalize ICP values and reduce the risks of secondary damage. However, if such monitoring is not available clinical examination and radiological criteria should be used. A major concern is how to taper the therapies employed for ICP control. The aim of this manuscript is to review the criteria for escalating and withdrawing therapies in TBI patients. Each step of the staircase approach carries a risk of adverse effects related to the duration of treatment. Tapering of barbiturates should start once ICP control has been achieved for at least 24 h, although a period of 2–12 days is often required. Administration of hyperosmolar fluids should be avoided if ICP is normal. Sedation should be reduced after at least 24 h of controlled ICP to allow neurological examination. Removal of invasive ICP monitoring is suggested after 72 h of normal ICP. For patients who have undergone surgical decompression, cranioplasty represents the final step, and an earlier cranioplasty (15–90 days after decompression) seems to reduce the rate of infection, seizures, and hydrocephalus.

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“…This was not one of our prespecified outcomes because the validity of cerebral oedema volume as a measure of improvement in brain injury is not established and there is no agreed method of measuring it (e.g. see Degos and colleagues 131 and Lescot and colleagues 132 ).…”

Section: Chinese Studies Of Head Coolingmentioning

confidence: 99%

Systematic review of head cooling in adults after traumatic brain injury and stroke

Harris

Andrews²,

Murray³

et al. 2012

Health Technol Assess

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Does Brain Swelling Increase Estimated Specific Gravity?

Abstract: Our findings do not support a causal link between brain swelling and eSG elevation. The eSG increase in severe TBI patients is not due to brain swelling.

Cited by 5 publications

References 13 publications

Estimated Specific Gravity with Quantitative CT Scan in Traumatic Brain Injury

Estimated Specific Gravity with Quantitative CT Scan in Traumatic Brain Injury

Escalate and De-Escalate Therapies for Intracranial Pressure Control in Traumatic Brain Injury

Systematic review of head cooling in adults after traumatic brain injury and stroke

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