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Query: UMLS:C0268318 (ICP)
 10,007 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

On the basis of a series of 75 patients, the practical use of Icp continuous long-term recording in severe head injuries without mass lesions or remaining deeply comatose after surgical procedures is critically analyzed. ICP monitoring alone seems to be not essential for prognosis. Conversely it is of much greater use as a guide to management (respirator treatment, osmotics, CSF drainage). If the pros and cons of the procedure are carefully weighed, it would appear that, for the time being, ICP long-term monitoring is justified only in comatose patients on intensive care.
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PMID:Long-term intracranial pressure monitoring in comatose patients suffering from head injuries. A critical survey. 60 50

It is not only for CSF-removal in conservative treatment of oedema and control of the effectiveness of osmo-onco-therapy, contricosteroids, anticholinergics and aldosterone-antagonists, that external CSF drainage in severe cerebral trauma has proved of value. It has also made it possible to assess objectively the indications for bitemporal craniotomy in raised intracrainial pressure with an acute midbrain syndrome caused by tentorial herniation. Continuous monitoring of ICP permits an intervention at the right time and prevents one from operating too late, namely at a moment, when manifest neurological signs already indicate cerebral decompensaervative steps failing, a bitemporal craniectomy is indicated: in this way we lower intracranial pressure, liberate the rostral brain stem out of its strangulation and improve cerebral perfusion and metabolism.
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PMID:[External ventricular drainage--a new aspect in the operative treatment of head injury (author's transl)]. 85 83

An elementary technique for discontinuously measuring intracranial pressure, ventricular chemistry, cellularity, and topography, employing percutaneous needle tapping of an implanted module consisting of a Rickham reservoir-ventricular catheter for the chronic monitoring of severe head injury patients is presented. The intracranial pathophysiological conditions (increased ICP, persistent CSF cellularity, xanthochromia and elevated protein levels, and hydrocephalus) occurring in seven so instrumental patients recovering from such injuries are reviewed. The simplicity, safety, and multidiagnostic capability of the system are emphasized.
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PMID:Chronic monitoring of head injury with an implantable ventricular module. 87 87

Five methods of therapy for increased ICP were used in the treatment of 32 head-injured patients. The effects of steroids could not be evaluated. Withdrawal of CSF was always effective because intracranial volume was reduced and pressure must follow, but because of brain swelling and collapse of the ventricular system in this group of patients, it was not an effective permanent form of therapy. Hypertonic Mannitol reduced ICP in nearly every case irrespective of the degree of brain damage or the height of ICP. Hyperventilation was least effective in the most severely ill patients, presumably due to the non-responsiveness of the cerebral vessels to changes in PaCO2. The poorest response of ICP seemed to be with hypothermia.
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PMID:Analysis of the response to therapeutic measures to reduce intracranial pressure in head injured patients. 93 13

The aim of this work was to evaluate the effect of hyperventilation and mannitol on brain volume during neurosurgical operations. The material comprises 30 cases of supratentorial tumours. pO2, pCO2, pH and lactate concentration were determined in the arterial blood and in 7 cases also in the CSF. It was established that hyperventilation sometimes fails to decrease ICP; it was observed that hyperventilation was more effective in decreasing brain volume of the pCO2 level decreased by 14,6 mm Hg on the average. The joint use of hyperventilation and hypertonic mannitol was found to be more effective. Neither of the above methods was effective in the case of cystic tumors.
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PMID:[Hyperventilation and mannitol administration during surgery in patients with space-occupying intracranial lesions]. 95 85

The authors present a four electrode rheographic technique for simiquantitative continuous measurement of CBV, by examining changes in cerebral tissue impedance induced by changes in blood content of the brain parenchyma. Correlation between the data obtained and ICP measurements permits conclusions regarding the behaviour of the cerebral blood bed. pCO2 regulates CBV, and the phenomenon is reversible according to a hystereris shaped time course in acute experiments. The rebound of ICP after sudden injections of CSF into the cisterna magna is of a vasogenic nature. Changes in CSF volume induce contrary changes in CBV. Pharmacological effects can be studied. The validity of the method is discussed.
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PMID:Rheographic assessment of cerebral blood volume and correlations with changes in intracranial pressure. 96 87

Today, ICP monitoring is used to facilitate the diagnosis, treatment, and prognosis of abnormal ICP profiles. The level of ICP is made readily available and impending ICP abnormalities can be detected by evaluation of compensation mechanisms. ICP monitoring can also be used to evaluate methods of ICP reduction as shown in Fig 5. It can also aid in determining the prognosis. A poor prognosis is indicated by a CPP of less than 30 mm. Hg, rising ICP in spite of treatment, and loss of compliance. ICP monitoring is useful only in the experienced hands of a neurosurgical team which is better qualified to interpret data in association with the clinical picture and determine a plan of treatment. They are also fully aware of and can guard against possible infection, CSF leakage, hematoma, and its consequences.
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PMID:Description and uses of intracranial pressure monitoring. 104 35

Results obtained with three different CSF ventricular drainage methods (intermittent with no outflow resistance, continuous against a positive pressure, continuous with pre-arranged positive pressure), were evaluated in fifty nine cases of traumatic cerebral lesions and spontaneous intracerebral hematomas with intracranial hypertension. Continuous CSF withdrawal gives better clinical results and is more effective in controlling intracranial pressure than intermittent drainage (50% vs 13% successes respectively). Results obtained with continuous drainage against a steady positive pressure and with a pre-arranged pressure ("tidal drainage") are almost similar. However an outflow resistance 3-5 mmHg higher than diastolic level of ICP represents a rational approach to the problem.
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PMID:The role of CSF ventricular drainage in controlling intracranial hypertension in patients with brain lesions. Comparison of three methods. Preliminary results. 130 4

Due to clinical requirements and to improve the handling of CSF drainage set we developed a new concept, consisting of an arrangement of constructions, which are already available. Besides other advantages, the set provides an ICP monitoring, a pump device and a protection of the air filter of the collecting tank for safer transport. Opening the system for the performance of diagnostic or therapeutic manoeuvres can therefore be avoided. This new equipment has been tested in 28 patients having a ventricular or lumbar CSF drainage with good results and has been quickly accepted by the medical staff. The construction is described in detail.
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PMID:[Initial experiences with a new cerebrospinal fluid collection system]. 149 13

CSF outflow resistance was studied in cats using the lumbar infusion tests. Different infusion rates were applied from 0.012 to 1.8 ml/min. ICP level obtained during infusions varied from 8.9 +/- 3.0 to 144.0 +/- 25.7 mmHg. The calculated resistance (R) values were within 75.2 +/- 14.4 to 255.6 +/- 71.2. mm Hg/ml/min. The relation between ICP and R are characterized by a curve which can be divided into three parts. First R rises until an ICP level of about 20 mmHg is reached, then R decreases fast until the ICP value is about 50 mmHg, a further drop is much slower and the ICP/R curve becomes almost parallel to the ICP axis. The possible reasons for the ICP dependent changes of R as well as the clinical importance of the results obtained are discussed.
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PMID:ICP dependent changes of CSF outflow resistance. 151 27


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