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

Since 1982, 23 hydrocephalic children have been studied for compensatory mechanisms of the cerebrospinal fluid system. The authors describe the method and results of a computerized pressure-elastance resorption test (CPERT), a spinal steady-state infusion test, in hydrocephalic children. Computerized analysis of the P/V and AMP/P curve provides valuable data that precisely describe the degree of disturbances of CSF dynamics. The following parameters were quantitatively determined: out-flow resistance, opening pressure, elastance, elasticity, reference pressure and optimum (break-point) pressure. It is concluded that the described test allows the differential diagnosis of chronic hydrocephalus in children. The value of optimum pressure (analysis of AMP-P relation) gives precise indications for surgery and the selection of a valve system with adequate opening pressure. In some cases, the CPERT test can be used instead of continuous ICP monitoring.
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PMID:Analysis of CSF dynamics by computerized pressure-elastance resorption test in hydrocephalic children. Indications for surgery. 373 Nov 75

The pulse pressure (PP) of the intracranial pressure pulse wave (ICPPW) was measured in experimental and clinical hydrocephalus: namely, obstructive and kaolin-induced hydrocephalus as an experimental study, and noncommunicating and communicating hydrocephalus as a clinical study. At approximately the same ICP level, the PP was much higher in the obstructive hydrocephalus group and slightly higher in the kaolin-induced hydrocephalus group than in the controls. Also the PP level in noncommunicating hydrocephalus patients [3.19 mm Hg (SD: 1.04)] was significantly (P less than 0.05) higher than that in the communicating hydrocephalus patients [1.88 mm Hg (SD: 0.60)]. The results of our research suggest that the stronger the disturbance of the communication of the CSF between cranial cavity and spinal cavity the higher the PP of ICPPW. This results from the distensibility of the spinal dural sac and exerts a great influence on the elasticity and the PP of the cranial system. It is reasonable, therefore, to suggest that a marked increase in the ratio of the PP to the ICP in the normal or slightly high ICP hydrocephalus may indicate disturbance of the CSF flow, especially loss of CSF communication between the cranial and spinal compartments.
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PMID:Changes in intracranial pressure (ICP) pulse wave following hydrocephalus. 375 4

A multiple shunt system has been employed in nine children with hydrocephalus combined with absent or insufficient communication with intracranial-filled spaces. The common feature of the different lesions to such a shunt system is a pressure difference, which can be adjusted by this procedure. There arise four general indications: the uniform drainage of CSF spaces which do not communicate with each other; the uniform drainage of CSF and other separate liquid filled intracranial spaces; to obtain gradual and steady diminution of enormously dilated CSF or other fluid-filled spaces; the use of both sides for shunting in cases with recurrent failures of a unilateral drainage. The postoperative efficacy of a multiple shunt can be proved by demonstrating evenly decreasing CSF and other fluid-filled cavities, and by equilibrium between their different pressures. Evaluation of possible shunt failure in a multiple system requires CT and ICP recordings.
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PMID:The value of multiple shunt systems in the treatment of nontumoral infantile hydrocephalus. 377 82

A method is described for monitoring the relationship between CSF pulse pressure and ICP in clinical patients. Highly significant linear relationships were found during 65 continuous ICP recordings in 58 patients. The slope value of this relationship showed a positive correlation with the elastance coefficient, a volume-pressure parameter assessed by bolus injection. However, the correlation was too weak to allow for a confident prediction of the elastance coefficient on the basis of CSF pulse pressure in the individual patient. This was attributed to the variable magnitude of the volume change underlying the CSF pulse pressure: the pulsatile variation in cerebral blood volume. This quantity was calculated on the basis of a mathematical model from the slope value and the elastance coefficient and was found to vary between 0.36 and 4.38 ml. During plateau waves a disproportionate increase in pulse pressure with the ICP was observed in contrast with a relative decrease in intracranial elastance. This phenomenon was ascribed to an increase in the pulsatile variation in cerebral blood volume. It is concluded that, under certain conditions, the intracranial volume-pressure relationship can be continuously monitored by means of CSF pulse pressure analysis. The findings during plateau waves suggest that the pulse pressure also reflects the state of the cerebral vasomotor tone.
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PMID:Clinical observations on the relationship between cerebrospinal fluid pulse pressure and intracranial pressure. 395 20

Methods for continuous ICP recording were further developed. Intraventricular pressure measurement requires puncture of the brain, and is susceptible to infection. For routine applications, therefore, preferential use is made of miniaturized pressure transducers which, without the need to open the dura, are simply implanted epidurally. In the absence of disorders of blood clotting, no complications, in particular no infections, were observed in more than 900 measurements. In the case of rapidly growing intracranial space-consuming processes, considerable intracranial pressure differences giving rise to intracranial mass shifts and even incarceration occur. These pressure gradients can also be measured and treated clinically. The pathological intracranial pressure curve shows typical wave dynamics with A, B, C and D waves, and pulsation changes. In intensive care, measurement permits rapid detection of complications, selective treatment and prognostic information, including the temporal definition of brain death. In neurological and neuropediatric diagnosis, ICP measurement differentiates between active hydrocephalus and cerebral atrophy/dystrophy, and here, as also in cystic cerebral changes, subdural effusions, etc., helps clarify the indication for surgery. In the case of "pseudo tumour cerebri", too, ICP measurement permits objectivation. In addition, it is also possible to determine directly the intracranial reserve space and the CSF dynamics (bolus/infusion test, pulse wave analysis).
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PMID:[Intracranial pressure recording. Principles, technics, results and possibilities]. 638 87

The effect of mannitol to decrease the raised ICP is well documented and mannitol is now widely used in clinical practice. However, its mechanism of lowering ICP still remains controversial, especially under the condition of vasogenic edema. The objective of this study is to reexamine and delineate the mechanism of ICP reducing effect of mannitol, using quantitative vasogenic edema model, specific gravimetric technique to measure the brain water content, and the method to estimate the CSF dynamics without disturbing the physiological condition of intracranial compartments in cats. Quantitative increase of water content of the white matter was produced by the infusion of 0.5 ml of normal saline though stereotaxically inserted 25-G needle into the left frontal white matter. In control group, cats were sacrificed and water content of the gray and white matter of each coronary sliced brain was measured by specific gravimetric technique. In the mannitol group, 20% of mannitol (2 g/kg) was administrated via femoral vein within 3 minutes. The maximum reduction of ICP was achieved at the average of 30 minutes. At this time, the cats were sacrificed and the water content of brain was measured in the same way as in the control group. PVI, Ro, If (Marmarou) were calculated before and after mannitol administration. In parameter group, BP, ICP, CVP, serum osmotic pressure and osmolarity were measured without terminating the experiment. The changes of water content of the gray and white matter before and after mannitol administration in the area of infusion edema were 80.7% to 80.8% and 76.8% to 77.1% respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The mechanism of intracranial pressure-reducing effect of mannitol]. 644 89

The case of a 56 year old female suffering from a carcinomatous meningitis with recurrent attacks of unconciousness is presented. The ischemic nature of the attacks was substantiated through a simultaneous recording of ICP, systemic arterial blood pressure, and EEG. Every syncope was clearly accompanied by 1) a typical ICP plateau-wave, 2) a systemic blood pressure wave of lower amplitude, 3) a considerable correlative diminution of the cerebral perfusion pressure and 4) a slowing down of the EEG. These phenomenons could be provoked by intraventricular injections of a few milliliters of artificial CSF, whereas a ventriculo-peritoneal shunting made them disappeared. The role played by the disturbances of the CSF flow in the production of the plateau waves is discussed.
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PMID:[Plateau wave, unexpected cause of anoxo-ischemic syncope. Reflections on the pathogenesis of the plateau wave apropos of a case]. 647 53

The influence of jugular vein ligation on CSF resorption was examined experimentally by means of a manometric ventricular infusion test in dogs. Capacity of CSF absorption was decreased in a stepwise manner according to whether unilateral or bilateral ligation of jugular veins was performed. Interestingly, in addition to rises in ICP, dural sinus pressure was predominantly elevated after bilateral jugular ligation, often exceeding the ICP level. The CSF malresorption observed was considered to be closely related to the lowered pressure gradients between ICP and intracranial sinus pressure.
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PMID:Effect of internal jugular vein ligation on resorption of cerebrospinal fluid. 657 88

ICP being a very significant parameter of intracranial pathology, it needs to be recorded continuously. ICP of 7 cases of normal pressure hydrocephalus (NPH) and 6 postoperative patients, for whom relationship between REM sleep and ICP was under discussion, was monitored at night and recorded by Brock's method. Polygraphic records also were obtained. Increased ICP was related to REM sleep in 3 of 6 postoperative cases. In the remaining 3 cases, REM sleep could not be observed the first postoperative night, and ICP was lower and stable all night. This fact may be an effect of anesthetic drugs. NPH patients were divided into 2 groups by pressure profile during night recording of ICP. One group of 2 cases demonstrated irregular ICP during REM sleep while the other group of 5 cases did not. The former 2 cases showed neurological improvement after shunt operations. In NPH cases, ICP has significance in deciding whether surgery is necessary. It appears reasonable to suggest that the augumentation of ICP during REM sleep in cases of hydrocephalus and postoperative condition is related to an increase in cerebral blood flow and an exhaustion of the absorptive mechanisms of CSF.
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PMID:[Intracranial pressure changes during sleep in man]. 668 71

Haemophilus influenzae type b (HIb) is the most common cause of bacterial meningitis in children with a mortality rate ranging from 1.6% to 14%. Most patients have a 2-3 day history of symptoms prior to admission. A few have fulminating disease with rapid neurological deterioration. Review of 191 cases of HIb meningitis revealed a mortality rate of 2.1% but all who died had fulminating meningitis (FM). Four of six patients with FM died. FM patients had symptoms for less than 24 hours before rapid neurological deterioration with increased ICP, seizures, coma and/or respiratory arrest. Review of 10 FM cases revealed that on admission, 5 had hypotension, 3 had thrombocytopenia, and 8 had coma. Typical CSF changes were seen in only 7. All fatal cases died within 24 hours. Brain swelling and tonsillar herniation were found at autopsy. SDS-PAGE outer membrane protein subtyping did not show one "killer strain". Animal and autopsy data suggest that diminished CSF outflow and cerebral edema contribute to increased ICP. To improve survival of FM patients, initial treatment must (1) decrease ICP below levels impairing cerebral perfusion, (2) maintain adequate ventilation and blood pressure, and include (3) LP when stable, (4) antibiotics, and (5) close monitoring. Utilizing these principles, two FM patients survived without major sequelae.
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PMID:Fulminating haemophilus influenzae b meningitis. 670 99


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