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- E Pfenninger and J Kilian.
- Anaesthesist. 1984 Feb 1; 33 (2): 115-20.
Abstract13 cases of severe cerebral trauma were subjected to varying degrees of elevation of the upper trunk (0 degrees, 15 degrees, 30 degrees, 45 degrees) and to head-raising only (0 degrees, 15 degrees, 30 degrees). The intracranial pressure and mean arterial pressure were measured in these positions. On raising the upper half of the body by 15 degrees, intracranial pressure fell from a mean of 35.3 mm Hg to 28.7 mm Hg, and to 25.2 mm Hg on raising to 30 degrees. Further elevation to 45 degrees resulted in an increase in pressure. In contrast, the mean arterial pressure fell constantly as elevation increased, resulting in a decrease in cerebral perfusion pressure at levels above 30 degrees. In no cases did raising of the head alone result in a lowering of pressure. Instead, potentially dangerous increases were observed.
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