Wirkung von Hyperventilation und Tham-Behandlung auf Hirndruck und elektrische Hirnaktivität im experimentellen Hirnödem

Oe, Knoblich; Gaab, M. R.; Schupp, Joachim; Dietrich, K.; Fuhrmeister, U.; Gruß, Peter

doi:10.1055/s-0028-1090331

Cited by 6 publications

(7 citation statements)

References 11 publications

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“…In contrast to pure decompression, these struc tures are not impaired. This explains the constancy of blood pressure reg ulation and the reappearance of spontaneous respiration, which we were not able to achieve with any other method of treatment after such a trauma [6,7,16].…”

Section: Effect O F Resection O F the Edematous Tissuementioning

confidence: 65%

“…Of a trial series totaling 44 cats [5][6][7]16], 6 were treated surgically and 6 untreated traumatized animals served as controls. In all cats (2.5-3.5 kg body weight), we produced an extensive cold trauma of the brain, following right parietal trepanation ( fig.…”

Section: Methodsmentioning

confidence: 99%

“…Even the massive rise in ICP 2 h after trauma [cerebral perfusion pressure -CPP = AP-VP -reaches critical values below 60 mm Hg; 10], is partly due to vasoparalysis, caused by acidosis, in the traumatized tissue. This is shown by the pronounced decrease in brain pressure caused by vaso constriction after Tris buffer [16]. 2 h after comparable cold injury, there is already pronounced brain edema in rats [11,15].…”

Section: Icp Eeg and Cerebral Metabolism After Traumamentioning

confidence: 99%

“…If there are no primary brain stem lesions of cerebral trauma, these symptoms are the consequence of a posttraumatic intracranial pressure (ICP) elevation [8,9,22,26]. This increase in volume results from cerebral expansion second ary to local softening of contusive foci [21,31], or from an increase in the intracranial vascular volume [10,16,29] and ends up in generalized brain edema [1,19,22,26].…”

Section: Introductionmentioning

confidence: 99%

“…This paper describes an experimental comparison of the effectiveness of decompression alone with that of resection of the traumatic brain edema, using comparative recording of ICP, EEG, circulatory parameters and cere bral arteriovenous metabolite differences [5][6][7]16]. …”

Section: Introductionmentioning

confidence: 99%

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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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Section: Effect O F Resection O F the Edematous Tissuementioning

confidence: 65%

Section: Methodsmentioning

confidence: 99%

Section: Icp Eeg and Cerebral Metabolism After Traumamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

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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Critical Intracranial Effects of Osmotherapy

Gaab¹,

Pflughaupt²,

Ratzka³

et al. 1978

Treatment of Hydrocephalus Computer Tomography

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Effect of furosemide (Lasix) on acute severe experimental cerebral edema

et al. 1979

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The effect of furosemide (Lasix) therapy on a standardized experimental cerebral edema, induced in rats by applying a cooling stamp to the right side of the skull over the right coronal suture by means of a stereotactic instrument, was examined. The hemispherically separated water and electrolyte contents of the brain were analyzed after 24 h. Following furosemide therapy, the behavior of these edema parameters was compared statistically with dexamethasone, glycerol and albumin. An increase of the water and sodium content, and a decrease of potassium was observed 24 h after the trauma, especially in the right hemisphere. Furosemide did not improve either the water content or the electrolyte balance. By contrast, the administration of dexamethasone, glycerol and albumin was followed by a significant improvement of the edema. In experiments with cats, the course of the edema and the effect of furosemide on the cold brain injury of the right hemisphere were observed by measuring the intracranial pressure (ICP) values, and by continuous monitoring of the EEG. The ventricular CSF pressure and epidural pressures were also recorded. The electrical brain activity was continuously compared with the course of the ICP by means of computer analysis. In addition, the blood osmolality and diuresis were monitored. The ICP increased rapidly after the trauma, establishing considerable pressure gradients, and the EEG power intensities decreased markedly on the right side. Histologically, there was an extended edema of the white matter of both hemispheres. The ICP was not lowered by single injections or high dose infusions of furosemide, and the EEG power intensities also did not improve. Infusions of large volumes of furosemide even resulted in an increase of ICP, but infusion of 40% sorbitol effected a rapid decrease of ICP and EEG recovery over the left hemisphere. Sorbitol infusion also caused a marked rise in the blood osmolality, whereas furosemide had no such effect. The results raise considerable doubts as to the propriety of the exclusive use of furosemide for cases of acute cerebral edema with raised ICP. The diuretic effect is insufficient to establish an osmotic gradient, and its general dehydrating effect does not acutely influence the ICP. The absence of effect on the experimental tissue edema would not appear to commend furosemide as basic therapy for cases of traumatic cerebral edema.

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Wirkung von Hyperventilation und Tham-Behandlung auf Hirndruck und elektrische Hirnaktivität im experimentellen Hirnödem

Cited by 6 publications

References 11 publications

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

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

Critical Intracranial Effects of Osmotherapy

Effect of furosemide (Lasix) on acute severe experimental cerebral edema

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