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

Decompressive craniectomy sometimes causes neurological deficits known as 'the syndrome of the sinking skin flap' or 'the symptom of the trephined'. These disorders can be corrected with cranioplasty, but there is no consensus on appropriate treatments. We report a case of successful correction of traumatic hydrocephalus following craniotomy. A 50-year-old man was admitted to our hospital with disturbance of consciousness after a head injury. Decompressive craniectomy was performed for a right acute subdural hematoma. His consciousness recovered after the operation, but then deteriorated gradually and left hemiparesis occurred. CT scan revealed midline shift from right to left. These symptoms and CT findings were not improved after cranioplasty, but were improved with removal of the CSF from the adhered subarachnoid space. The diagnosis was traumatic hydrocephalus, and a cisternoperitoneal shunt was subsequently placed. We report this case to emphasize the necessity for study of CSF circulation, as well as the importance of examination of CBF and ICP after craniectomy.
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PMID:[A case of the traumatic hydrocephalus after large craniectomy for acute subdural hematoma]. 1261 57

In the present study, we attempted to assess the mechanisms underlying the neuroprotective effect of hypervolaemic haemodilution in rat heatstroke. In anaesthetized rats treated with normal saline (NS) immediately after the onset of heatstroke induced by T (a) (ambient temperature) of 42 degrees C for 88 min, followed by T (a) of 24 degrees C for 12 min, the values for MAP (mean arterial pressure), ICP (intracranial pressure), CPP (cerebral perfusion pressure), CBF (cerebral blood blow), brain P O(2) (partial pressure of O(2)) and striatal glutamate, glycerol, lactate/pyruvate ratio, hydroxyl radicals and neuronal damage score were 42+/-3 mmHg, 33+/-3 mmHg, 9+/-3 mmHg, 109+/-20 BPU (blood perfusion units), 6+/-1 mmHg, 51+/-7 micromol/l, 24+/-3 micromol/l, 124+/-32, 694+/-22% of baseline and 2.25+/-0.05 respectively. In animals treated with 10% albumin immediately after the onset of heatstroke ( T (a) of 42 degrees C for 88 min), the values for MAP, ICP, CPP, CBF, brain P O(2) and striatal glutamate, glycerol, lactate/pyruvate ratio, hydroxyl radicals and neuronal damage score were 64+/-6 mmHg, 10+/-2 mmHg, 54+/-5 mmHg, 452+/-75 BPU, 15+/-2 mmHg, 3+/-2 micromol/l, 4+/-2 micromol/l, 7+/-3, 119+/-7% of baseline and 0.38+/-0.05 respectively. Apparently, the heatstroke-induced arterial hypotension, intracranial hypertension, cerebral hypoperfusion, cerebral ischaemia, brain hypoxia, increased levels of striatal glutamate, glycerol, lactate/pyruvate ratio and hydroxyl radicals, and increased striatal neuronal damage score values were all attenuated significantly by the induction of hypervolaemic haemodilution in rats immediately at the onset of heatstroke. These results demonstrate that the neuroprotective effect of hypervolaemic haemodilution is associated with a decrease in the elevation of glutamate, glycerol, lactate and free radicals in brain exposed to experimental heatstroke-induced cerebral ischaemia/hypoxia injury.
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PMID:Effect of hypervolaemic haemodilution on cerebral glutamate, glycerol, lactate and free radicals in heatstroke rats. 1468 77

Over the last decade, routine neuromonitoring of ICP and CPP has been extended with new on-line techniques such as microdialysis, tissue oxygen (ptiO(2)), acid-base balance (ptiCO(2), pH) and CBF measurements, which so far have not lead to clear-cut therapy approaches in the neurointensive care unit. This is partially due to the complex pathophysiology following a wide-range of brain injuries, and the lack of suitable animal models allowing simultaneous, clinically relevant neuromonitoring under controlled conditions. Therefore, a controlled cortical impact (CCI) model in large animals (pig) has been developed. After placement of microdialysis, ptiO(2), temperature and ICP catheters, an unilateral CCI injury (2.6-2.8 m/sec velocity, 9 mm depth, 400 ms dwell time) was applied and neuromonitoring continued for 10 h. CCI caused a rapid drop in CPP, ptiO(2) and glucose, whereas ICP, glutamate and lactate increased significantly. Most parameters returned to baseline values within hours. Lactate stayed elevated significantly throughout the experiment, but the lactate-to-pyruvate ratio (LPR) changed only slightly, indicating no severely ischemic CBF. Contralateral parameters were not affected significantly. Evaluation of brain water content and histology (12 h post-CCI) showed ipsilateral brain swelling by 5% and massive cell damage underneath the injury site which correlated with changes of ICP, CPP, glutamate, lactate, and ptiO(2) within the first hours post-CCI. Moderate controlled cortical contusion in pigs induced a complex pattern of pathophysiological processes which led to 'early' histological damage. Thus, this new large animal model will enable us to investigate the effect of therapeutic interventions on multi-parametric neuromonitoring and histological outcome, and to translate the data into clinical practice.
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PMID:Moderate controlled cortical contusion in pigs: effects on multi-parametric neuromonitoring and clinical relevance. 1474 78

Hyperventilation can rapidly lower ICP, but because it induces a consistent reduction in CBF and because the effects on ICP are transient, the only role that hyperventilation plays in the management of intracranial hypertension is in the management of acute elevations in ICP. In these circumstances, hyperventilation can be life-saving and can temporize until more definitive treatment of the intracranial hypertension can be undertaken.
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PMID:Every breath you take: hyperventilation and intracranial pressure. 1496 73

Cerebral blood flow and ICP are important neurophysiologic parameters known to be affected by pathology and by trauma. Limited data on the relationship between these parameters following head trauma is inconsistent with regard to whether these parameters are correlated. Data on the relationship between these parameters in the healthy state is not readily available due to a lack of noninvasive means to measure these important parameters. A recently developed noninvasive MRI-based method for simultaneous measurement of total cerebral blood flow and intracranial pressure was applied to establish the relationship between ICP and TCBF values in healthy subjects. Seventy-one simultaneous measurements of CBF and ICP were obtained from 23 healthy young adults. These results demonstrated that CBF values span over a much narrower range compared with ICP. The relationship between the inter-individual CBF and ICP measurements suggest that in the healthy state and in rest these parameters are not correlated.
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PMID:Relationship between total cerebral blood flow and ICP measured noninvasively with dynamic MRI technique in healthy subjects. 1646 48

ICM+ software was introduced into the Cerebrospinal Fluid (CSF) Dynamics Laboratory, Addenbrooke's Hospital, Cambridge, UK, in 2003. Since then 1,447 constant rate infusion tests and 123 overnight ICP monitoring sessions (using intraparenchymal bolt) were performed. Various configurations were used: ICP only (identification of CSF dynamics model and overnight ICP monitoring with analysis of compensatory reserve and B waves); ICP and arterial pressure (ABP; analysis of the pressure reactivity index); ICP, ABP and transcranial Doppler blood flow velocity (for assessment of cerebral autoregulation); ICP, ABP and near-infrared spectroscopy (for analysis of the fluctuation of cerebral blood volume); ICP, sagittal sinus pressure and jugular vein pressure (in patients with idiopathic intracranial hypertension to assess the hydrodynamic consequences of cerebral venous sinus stenosis). To assess vascular factors of hydrocephalus a combination of CSF infusion study with PET-CBF studies was performed. The software contains a database of the shunts tested in the Cambridge Shunt Evaluation Laboratory, aiding shunt assessment in vivo in the case of possible underdrainage or overdrainage. The software also enables the digital recording of data, ready for post-hoc manual or batch analysis, the creation of virtual signals (such as critical closing pressure, cerebral compliance etc.) and analysis of their dependency on primary modalities. A collected database of cases and signals forms a powerful reference tool in the investigation and understanding of the complex pathophysiology of hydrocephalus.
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PMID:ICM+: a versatile software for assessment of CSF dynamics. 2232 67

Paediatric traumatic brain injury (TBI) is a leading cause of death and disability. Previous studies showed neuroprotection after TBI by (endo)cannabinoid mechanisms, suggesting involvement of cannabinoid receptors (CBR). We therefore determined CBR densities and expression of the translocator protein 18 kDA (TSPO) in newborn piglets after experimental TBI. Newborn female piglets were subjected to sham operation (n=6) or fluid-percussion (FP) injury (n=7) under controlled physiological conditions. After six hours, brains were frozen, sagittally cut and incubated with radioligands for CBR ([3HCP-55,940, [3H]SR141716A) and TSPO ([3H]PK11195), an indicator of gliosis/brain injury. Early after injury, FP-TBI elicited a significant ICP increase at a temporary reduced cerebral perfusion pressure; however, CBF and CMRO2 remained within physiological range. At 6 hours post injury, we found a statistically significant increase in binding of the non-selective agonist [3H]CP-55,940 in 15 of the 24 investigated brain regions of injured animals. By contrast, no significant changes in binding of the CB1R-selective antagonist [3H]SR141716A were observed. A non-significant trend towards increased binding of [3H]PK11195 was observed, suggesting an incipient microglial activation. We therefore conclude that in this model and time span after injury, the increase in [3H]CP-55,940 binding reflects changes in CB2R density, while CB1R density is not affected. The results may provide explanation for the neuroprotective properties of cannabinoid ligands and future therapeutic strategies of TBI.
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PMID:Early increase of cannabinoid receptor density after experimental traumatic brain injury in the newborn piglet. 2499 29


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