Prevention and treatment of intracranial hypertension

Jantzen, J

doi:10.1016/j.bpa.2007.09.001

Cited by 61 publications

(53 citation statements)

References 23 publications

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“…A rapid increase within seconds is frequently associated with a stress response or triggering of autonomic dysfunctions via the vagal or glossopharnygeal nerves or carotid bodies, 25 whereas an increase within minutes is likely because of local venous obstruction. 26 The latter may result from bilateral jugular vein compression when the part of the Sovika device covering the anterior neck is fitted. The advantage regarding cooling efficacy via supplementary neck coverage may be disadvantageous regarding venous drainage leading to rise in ICP.…”

Section: March 2013mentioning

confidence: 99%

Induction of Cooling With a Passive Head and Neck Cooling Device

Poli

Purrucker

Priglinger

et al. 2013

Stroke

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Background and Purpose— Therapeutic hypothermia improves clinical outcome after cardiac arrest and appears beneficial in other cerebrovascular diseases. We conducted this study to investigate the relationship between surface head/neck cooling and brain temperature. Methods— Prospective observational study enrolling consecutive patients with severe ischemic or hemorrhagic stroke undergoing intracranial pressure (ICP) and brain temperature monitoring. Arterial pressure, ICP, cerebral perfusion pressure, heart rate, brain, tympanic, and bladder temperature were continuously registered. Fifty-one applications of the Sovika cooling device were analyzed in 11 individual patients. Results— Sovika application led to a significant decrease of brain temperature compared with baseline with a maximum of −0.36°C (SD, 0.22) after 49 minutes (SD, 17). During cooling, dynamics of brain temperature differed significantly from bladder (−0.25°C [SD, 0.15] after 48 minutes [SD, 19]) and tympanic temperature (−1.79°C [SD, 1.19] after 37 minutes [SD, 16]). Treatment led to an increase in systolic arterial pressure by >20 mm Hg in 14 applications (n=7 patients) resulting in severe hypertension (>180 mm Hg) in 4 applications (n=3). ICP increased by >10 mm Hg in 7 applications (n=3), led to ICP crisis >20 mm Hg in 6 applications (n=3), and a drop of cerebral perfusion pressure <50 mm Hg in 1 application. Conclusions— Although the decrease of brain temperature after Sovika cooling device application was statistically significant, we doubt clinical relevance of this rather limited effect (−0.36°C). Moreover, the transient increases of blood pressure and ICP warrant caution.

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Section: March 2013mentioning

confidence: 99%

Induction of Cooling With a Passive Head and Neck Cooling Device

Poli

Purrucker

Priglinger

et al. 2013

Stroke

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show abstract

“…Values of ICP lower than10 mm Hg (tolerated up to 20 mm Hg), cerebral perfusion pressure (CPP) over 70 mm Hg and mean arterial pressure (MAP) from 70 to110 mm Hg are considered normal or desirable values. (8) Increases of ICP may cause decrease of CPP, if there is no concomitant increase of MAP. (7) This decrease results in circulatory impairment with cerebral hypoxia and increase of cerebral edema, that in the more severe cases can lead to encephalic death.…”

Section: Discussionmentioning

confidence: 99%

“…(1,6) Monitoring of ICP is indicated for all patients with BI with a possibility of neurological recovery, with values of the Glasgow Coma Scale (GCS) from 3 to 8 and with abnormal findings at computerized tomography (CT). (7,8) During recovery of neurological injury some of the fundamental procedures are mechanical ventilation and deep sedation. In these conditions there is a major risk of pulmonary complications.…”

Section: Discussionmentioning

confidence: 99%

Efeitos da fisioterapia respiratória na pressão intracraniana e pressão de perfusão cerebral no traumatismo cranioencefálico grave

Toledo¹,

Garrido²,

Troncoso³

et al. 2008

Rev. bras. ter. intensiva

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“…mannitol 0.25 to 2 g/kg as 20% solution IV over at least 30 minutes, administered not more frequently than every 6 to 8 hours) is commonly administered. In selected cases forced hyperventilation (aiming a paCO2 lower than 25 mmHg), barbiturate coma, high dose indomethacin administration and bilateral decompressive craniectomy should be taken into consideration (Jantzen 2007).…”

Section: Encephalopathy Related To the Underlying Diseasementioning

confidence: 99%