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

The intraventricular pressure was compared with conductance to outflow of CSF (Cout) in 12 patients with high-pressure hydrocephalus of less than 3 months duration. Cout was measured by a lumbo-ventricular or a ventriculo-ventricular perfusion test. In all patients Cout was very low (median 0.016 ml mm Hg-1 minute-1). Thus high-pressure hydrocephalus may be considered to be the consequence of a greatly increased resistance to resorption of CSF. The level of the measured ICP (mean: ICP 23.5 mm Hg) corresponded to the theoretical level calculated from the measured Cout. B-waves were observed during most of the recording periods and episodes of plateau waves were seen in all patients but one. In this particular group of patients, the unsatisfactory results of ventriculo-atrial shunting emphasize the high risks associated conditions leading to high-pressure hydrocephalus.
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PMID:The conductance to outflow of CSF in adults with high-pressure hydrocephalus. 712 73

The authors clinical experience in the continuous subarachnoid monitoring of ICP (SaP) is reported. It is stressed that the outline and the absolute pressure values of the recordings are not significantly affected by CSF leakage. No complication was observed in any of the monitored cases.
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PMID:The value of continuous subarachnoid monitoring of ICP with reference to the leakage of CSF. 721 55

Long-term ICP recording was carried out in 151 acute head injury patients- 131 comatose patients admitted to ICU, and 20 non-comatose patients harbouring intracerebral mass lesions (lacerations or haematomas) in whom a decision to operate was doubtful. CSF withdrawal was used in 39 cases: by intermittent subtraction in 23 patients, and by continuous ventricular drainage (VD) in the remainder. In the acute stage, within 72 hours or injury, CSF subtraction proved of little use in influencing ICP or clinical time course. Conversely, at a latter stage, CSF withdrawal either by repeated intermittent subtraction or by continuous VD could very often control raised ICP. However, some patients had to undergo permanent shunting eventually. Elevated ICP was also safely controlled in four out of eight patients with intracerebral mass lesions and stationary symptoms. Such patients recovered quickly, and operation was avoided.
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PMID:CSF withdrawal for the treatment of intracranial hypertension in acute head injuries. 727 Feb 57

Thirty-six patients with SAH were submitted to continuous ICP monitoring: in 33 cases a continuous ventricular fluid pressure recording was performed in acute stage. According to Hunt and Hess, 2 patients were graded I, one II, one III, 13 IV and 16 V. In the remaining 3 cases who developed a normal pressure hydrocephalus 15, 20 and 40 days from bleeding an extradural miniaturized transducer was applied. B and C waves were common findings in acutely recorded patients. Typical A waves accompanied base line recordings in patients with NPH. From analysis of data the authors evidenced that elevated ICP values have been registered not only in patients graded as III, IV and V but also in those graded I and II: as 89% of patients belong to grades IV and V it was impossible to correlate clinical status with ICP. In patients with spasm it was never noted ICP values higher than 20 mmHg during recording time (from 60 hours to 10 days). In order to reduce intracranial hypertension CSF drainage was performed in 33 patients acutely registered. In patients graded I and II this procedure was followed by an ICP reduction and an improvement of the clinical status. In none of the patients graded IV and V in spite of pressure maintained at 10 mmHg, CSF drainage affected clinical evolution.
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PMID:Intracranial pressure in subarachnoid hemorrhage. Preliminary report in 36 cases. 733 18

This study is based on 11 cases with pseudotumour cerebri. In each case a high dose of Escin was administered intravenously, and the drug effect during ICP recording was observed. In seven cases the drug manifested a significant hypotensive effect. In these cases the treatment with Escin (20 mg every 8 hours) was continued for 3 days; the control if ICP after this period showed a normal pressure in all cases. Oral treatment was continued at the same dosage for 20-30 days and the patient was then discharged. All patients presented complete remission of the clinical syndrome and fundus normalization. Follow-up after a year showed no recurrence. In three cases the treatment with Escin was unsuccessful; these patients were given dexamethasone, with normalization of the syndrome. Another case that presented with a severe picture of intracranial hypertension and visual impairment was treated with Escin and dexamethasone without positive results. The patient improved with external CSF drainage, and was treated by a shunt procedure that induced remission of the syndrome.
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PMID:Treatment of benign intracranial hypertension. 736 93

In 56 neurosurgical patients 70 percutaneous needle trephinations were performed. This method was mostly used in patients with acute increase of ICP due to occlusive hydrocephalus of various aetiologies. Thanks to the accuracy and exhaustiveness of CT information, and thanks to the simplicity and safety of percutaneous needle trephination, this latter could be more and more used in the daily clinical practice as a diagnostic and therapeutic procedure, for example for the study of adult hydrocephalus, for provisional external ventricular drainage, for treatment of CSF infections, and for ventricular bleedings (also in newborns and premature infants). No serious complication was seem even after prolonged CSF drainage over a period of 41 days. The method of PNT, as described in detail, can be used under sterile conditions at the bedside, on the stretcher in the emergency room, or in the CT or X-ray laboratory. It fulfils the criteria for clinical acceptance: simplicity, low risk, reliability, exactness, and effectiveness.
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PMID:Clinical value of percutaneous needle trephination (PNT). 744 29

In patients requiring ICP monitoring, a ventricular catheter connected to an external strain gauge transducer or catheter-tip pressure transducer device is the most accurate and reliable method of monitoring ICP, and enables therapeutic CSF drainage. Clinically significant infections or hemorrhage associated with ICP devices causing patient morbidity are rare and should not deter the decision to monitor ICP. Parenchymal catheter-tip pressure transducer devices measure ICP, similar to ventricular ICP pressure, but have the potential for significant measurement differences and drift due to the inability to recalibrate. These devices are advantageous when ventricular ICP is not obtained or if there is obstruction in the fluid coupling. Subarachnoid or subdural fluid-coupled devices and epidural ICP devices are currently less accurate.
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PMID:Intracranial pressure monitoring techniques. 749 47

The authors present the policy they have worked out for hydrocephalus patients with special reference to the pressure measurement and test methods and to rCBF, SPECT and transcranial Doppler sonography (TDC) studies. For diagnosis, the protocol proposed by Gjerris and Borgesen was followed in 75 cases: besides other methods (CT, radionuclide cisternography, MRI) the intracranial pressure waves routinely recorded and analyzed by means of ventricular catheters for 24 h. The patients were roughly divided into groups in terms of diagnosis, baseline pressure, compliance, results of infusion tests and of surgery. In 13 patients the investigations were supplemented by rCBF SPECT and in 42 patients by TCD studies before and after CSF shunting or withdrawal to analyze the acute effects on cerebral circulation. Clinical follow-up shows that need for shunting was indicated fairly well by the common results of baseline ICP, compliance and infusion loading. The rCBF SPECT studies revealed a significant increase of the cerebral perfusion at the basal ganglia after shunting while, on the basis of CBF velocity changes three types of vasoregulatory response could be defined with TCD. In our hands, monitoring of the pressure and craniospinal capacity has proved to be a valuable aid in decisions on surgery; however, for a more precise (and beneficial) appreciation of whether surgery is indicated the vasoregulatory responses should also be taken into account in future.
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PMID:Our policy in diagnosis and treatment of hydrocephalus. 775 7

Investigation into the use of osmotic therapy for ICP reduction began in 1919. Mannitol is the osmotic agent currently in use. Mannitol's effectiveness in reducing ICP has been shown. Osmotic therapy using mannitol reduces ICP by mechanisms that remain unclear. Mannitol is thought to decrease brain volume by decreasing overall water content, to reduce blood volume by vasoconstriction and to reduce CSF volume by decreasing water content. Mannitol may also improve cerebral perfusion by decreasing viscosity or altering red blood cell rheology. Lastly, mannitol may exert a protective effect against biochemical injury. The most common complications of therapy are fluid and electrolyte imbalances, cardiopulmonary edema and rebound cerebral edema. Nursing care of the patient receiving mannitol requires vigilant monitoring of electrolytes and overall fluid balance, and observation for the development of cardiopulmonary complications in addition to neurologic assessment.
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PMID:Mannitol revisited. 796 23

Complications of continuous registration of intracranial pressure were studied prospectively over a 2 year period in two groups of patients with head injuries (HI) and spontaneous intracranial haemorrhages (ICH). 53 patients of total 234 patients with head injuries and 68 patients of total 185 patients with spontaneous haemorrhages were studied. The time of ICP recording varied from 7.57 days (mean) in patients with ICH and 6.16 days (mean) in patients with HI respectively depending on the clinical situation. Subcortical parenchymatous haemorrhages (less than 0.5 cm in diameter) were observed in 6 patients. 2 patients suffered from meningitis but had associated rhinogenic CSF fistulas. In 16 cases without clinical signs of meningitis bacterial contamination of the catheter or the CSF was observed. Dislocation of the ventricular catheter during transport occurred in another 7 patients. In 6 cases the ventricular catheter occluded and had to be replaced. There were no statistical significant differences concerning the frequency of the different complications in both groups. From the low complication rate we conclude that ventriculostomy still is the "golden standard" of ICP recording.
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PMID:[Complications in measuring ventricular pressure in patients with craniocerebral trauma and spontaneous intracranial hemorrhage--a prospective study]. 805 77


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