Journal of neurosurgery
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Journal of neurosurgery · Aug 1998
Comparative StudyRelationships among cerebral perfusion pressure, autoregulation, and transcranial Doppler waveform: a modeling study.
The aim of this study was to analyze how the main values extrapolated from the transcranial Doppler (TCD) waveform (systolic, mean, and diastolic velocity; velocity peak-to-peak amplitude; and pulsatility index [PI]) are affected by changes in intracranial pressure (ICP), systemic arterial pressure (SAP), autoregulation, and intracranial compliance. ⋯ The information contained in the TCD waveform is affected by many factors, including ICP, SAP, autoregulation. and intracranial compliance. Model results indicate that only a comparative analysis of the concomitant changes in ultrasonographic quantities during multimodality monitoring may permit the assessment of several aspects of intracranial dynamics (cerebral blood flow changes, vascular pulsatility, ICP changes, intracranial compliance, CPP, and autoregulation).
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Journal of neurosurgery · Aug 1998
Selection of severely head injured patients for mild hypothermia therapy.
The authors have analyzed the efficacy of inducing mild hypothermia (34 degrees C) in 62 severely head injured patients to control fulminant intracranial hypertension. ⋯ The authors conclude that mild hypothermia is effective for preventing ICP elevation in patients without diffuse brain swelling in whom ICP remains higher than 20 mm Hg but less than 40 mm Hg after conventional therapies.
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The authors report on the surgical anatomy of the juxta-dural ring area of the internal carotid artery to add to the information available about this important structure. ⋯ An aneurysm arising from the medial side of the juxta-dural ring area even below the tuberculum sellae is a potential cause of subarachnoid hemorrhage.