Intracranial pressure and pressure volume relation in patients with subarachnoid haemorrhage (SAH)

Hase, U.; Reulen, H. J.; Fenske, A.; Schürmann, K.

doi:10.1007/bf01401631

Cited by 30 publications

(8 citation statements)

References 13 publications

(17 reference statements)

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“…In the intensive care setting a significant correlation between ICP and H&H grades has been described in patients with SAH. [13][14][15][16] This finding is in agreement with the result of the current study in which a significant correlation between H&H grade and ICP before 13 In a recent study lumbar cerebrospinal fluid pressure was measured in patients subjected to craniotomy in the supine position. A decrease in ICP averaging 1.8 mmHg was found with 30º of head-up position, whereas CPP and MABP did not change significantly.…”

Section: Discussionsupporting

confidence: 94%

“…12 In patients with cerebral aneurysms a significant association between ICP and Hunt & Hess (H&H) gradation has been demonstrated in the intensive care setting. [13][14][15][16] However, in 1 perioperative study this relationship was not found. 17 Recently, we found that in patients with space-occupying lesions cerebral swelling occurs with a 5% probability at ICP less than 5 mmHg and a 95% probability at ICP more than 13 mmHg.…”

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confidence: 56%

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The Effects of 10?? Reverse Trendelenburg Position on Subdural Intracranial Pressure and Cerebral Perfusion Pressure in Patients Subjected to Craniotomy for Cerebral Aneurysm

Tankisi

Rasmussen

Juul

et al. 2006

Journal of Neurosurgical Anesthesiology

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The aim of the current study was to examine the effects of 10 degrees reverse Trendelenburg position (rTp) on subdural intracranial pressure (ICP), cerebral perfusion pressure (CPP), and dural tension. Additionally, the relationship between preoperative Hunt and Hess (H and H) grade and the subdural ICP in patients scheduled for cerebral aneurysm surgery was investigated. Twenty-eight consecutive patients with a cerebral aneurysm were subjected to craniotomy in propofol/fentanyl or propofol/remifentanil anesthesia. Subdural ICP was measured after opening of the bone flap and exposure of dura. After reference measurements of subdural ICP and mean arterial blood pressure (MABP), the measurements were repeated during 10 degrees rTp. No significant differences between the anesthetic groups were disclosed. During 10 degrees rTp, a significant decrease in MABP, ICP, and jugular bulb pressure was observed whereas CPP remained unchanged. In H and H 0 patients (unruptured aneurysm), the ICP decreased from 2.9 +/- 2.6 mmHg to 0.4 +/- 2.2 mmHg at 10 degrees rTp. In H and H I to II patients, the ICP decreased from 9.3 +/- 3.8 mmHg to 4.6 +/- 3.3 mmHg at 10 degrees rTp. A significant difference in the mean baseline subdural ICP and DeltaICP (change in ICP) was found between patients with unruptured aneurysm and patients with subarachnoid hemorrhage (H&H I and II). Furthermore, the relationship between the subdural ICP at neutral position and DeltaICP was significant. In patients without intracranial hypertension, 10 degrees rTp decreases subdural ICP and dural tension in patients with ruptured as well as patients with unruptured cerebral aneurysm; CPP is unchanged.

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Section: Discussionsupporting

confidence: 94%

contrasting

confidence: 56%

The Effects of 10?? Reverse Trendelenburg Position on Subdural Intracranial Pressure and Cerebral Perfusion Pressure in Patients Subjected to Craniotomy for Cerebral Aneurysm

Tankisi

Rasmussen

Juul

et al. 2006

Journal of Neurosurgical Anesthesiology

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“…The growth of brain edema volume and the depletion of CSS volume buffering capacity observed during the 3-5-day post trauma period, confirm data gathered on brain edema dynamics by several other authors using other methods (Kobrine and Kempe 1973;Hase et al 1978;Auer 1979;Reulen et al 1980;Cao et al 1984). …”

Section: Discussionsupporting

confidence: 88%

Traumatic Brain Edema in the Pathogenesis of Post-traumatic Hydrocephalus

Tjuvajev¹,

Eelmäe²,

Tomberg³

et al. 1991

Hydrocephalus

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Summary. The subjects of this prospective study were 64 consecutively admitted severely head injured patients with Glasgow coma scale (GCS), scores of <8. In 25 surviving patients the rate of ventricular dilatation was estimated by Evans index (EI) one month after injury and compared with the volume of brain edema, measured by the volumetric edema index (VEl), on computerized tomography (CT) (16~22 HU) in the acute period. A repetitive 2 ml bolus injection method was used for calculating the viscoelastic parameters of the craniospinal system (CSS). This study showed that the rate of posttraumatic hydrocephalus, defined as an EI >0.3, correlated more with the volume of brain edema measured during post-trauma days 3-5 and did not significantly correlate with the VEl of the first 36h post injury. Throughout the period of study the CSF resorption resistance (R) remained within the normal range «lOmmHg/ml per min). At 1 month after injury intracranial pressure (ICP), pressure volume index (PVI), and elastance (E) showed the increase of the volume buffering capacity of the CSS. These data support the view that post-traumatic hydrocephalus development is mainly caused by the atrophy of injured and edematous brain tissue. Thus, in such cases shunting procedures are not appropriate.

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“…42 Studies have demonstrated that when ICP is unresponsive to medical therapy, there is an increase in poor outcome. [43][44][45][46][47][48][49] Recent literature has begun to question the practice variation in ICP monitoring, 50,51 and the optimal target for interventions aimed to treat ICP. 52…”

Section: Intracranial Pressurementioning

confidence: 99%