• Acta neurochirurgica · Jan 1985

    Epidural monitoring of the intracranial pressure in severe head injury characterized by non-localizing motor response.

    • H K Nordby and N Gunnerød.
    • Acta Neurochir (Wien). 1985 Jan 1; 74 (1-2): 21-6.

    AbstractRecent studies on prognostic variables and the intensive care of head injuries enabled us to select 64 patients and administer a standard treatment protocol to prevent secondary brain injury. All the patients were in coma with a flexor motor pattern as the best response between 6 and 24 hours after the accident and/or decompressive surgery. Continuous epidural intracranial pressure (ICP) monitoring was used in all patients to control the effect of positioning, analgetics, hyperventilation and osmotherapy. None of the patients with a normal initial ICP (15 mm Hg or less) developed an ICP increase leading to brain tamponade. A subsequent further rise to 40 mm Hg signified a very high risk of progression towards brain tamponade. The majority of the patients (71%) with a maximum ICP increase of less than 40 mm Hg had an acceptable recovery. After 6-12 months, the outcome in this series of patients was 48% with a good/moderate recovery, 14% with severe deficits and 38% dead/vegetative.

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