Acta neurochirurgica
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Placement of ventricular catheters is a routine procedure in neurosurgery. Ventricle puncture is done using a flexible ventricular catheter stabilised by a solid steel mandrin in order to improve stability during brain penetration. A correct catheter placement is confirmed after removing the solid steel mandrin by observation of cerebrospinal fluid (CSF) flow out of the flexible catheter. Incorrect placement makes further punctures necessary. The newly developed device allows CSF flow observation during the puncture procedure and in addition precise intracranial pressure (ICP) measurement. ⋯ Advantages of the new technique are less puncture procedures with a lower risk of damage to neural structures and reduced risk of intracranial haemorrhages. Implantation of the ventricular catheter to far into the brain can be monitored and this complication can be overcome. Using the connected pressure monitoring tube an exact measurement of the opening intracranial pressure can be obtained performed without losing CSF.
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Acta neurochirurgica · Jul 2005
Trigeminocardiac reflex during skull base surgery: mechanism and management.
We study the occurrence and management of the trigeminocardiac reflex (TCR) during neurosurgical procedures for lesions of the skull base. ⋯ Due to the intracranial course of the trigeminal nerve several surgical procedures at the anterior, middle and posterior skull base may elicit the trigeminocardiac reflex. Continuous monitoring of hemodynamic parameters allows the surgeon to interrupt surgical manoeuvres immediately upon the occurrence of the TCR. This technique is sufficient for the heart rate and the arterial blood pressure to return to normal levels without the necessity of additional anticholinergic medication.
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Acta neurochirurgica · Jul 2005
Comparative StudyIntracranial pressure changes during fluid percussion, controlled cortical impact and weight drop injury in rats.
In traumatic brain injury research, the fluid percussion injury (FPI) model in the rat is widely used. The injury is graded based on indirect criteria, such as the extracranial pressure wave and/or physiological responses to the injury. We designed this study to investigate if the extracranially monitored pressure in the FPI-device corresponded to the actual intracranial situation. Severe controlled cortical impact (CCI) and severe weight drop injury (WDI) were studied for comparison. ⋯ The extracranial pressure pulse appears to be a good estimate of the intraventricular pressure pulse generated during FPI. Severe CCI and WDI generated intraventricular pressure pulses of much lower magnitude than FPI, explaining the lesser degree of brain stem involvement in the former models.