Acta neurochirurgica. Supplement
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Acta Neurochir. Suppl. · Jan 2008
Cerebral metabolism monitoring during hypothermia following resuscitation from cardiopulmonary arrest.
The aim of the present study was to evaluate cerebral metabolism monitoring during therapeutic hypothermia for global ischemic brain damage after cardiopulmonary resuscitation (CPR). ⋯ The measurement of cerebral metabolism parameters, especially OEF, might be useful for estimation of hypothermia therapy in patients with unconsciousness after resuscitation after cardiac arrest.
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Acta Neurochir. Suppl. · Jan 2008
Mathematical models of cerebral hemodynamics for detection of vasospasm in major cerebral arteries.
Vasospasm is a common complication of aneurismal subarachnoid hemorrhage (SAH) that may lead to cerebral ischemia and death. The standard method for detection of vasospasm is conventional cerebral angiography, which is invasive and does not allow continuous monitoring of arterial radius. Monitoring of vasospasm is typically performed by measuring Cerebral Blood Flow Velocity (CBFV) in the major cerebral arteries and calculating the Lindegaard ratio. We describe an alternative approach to estimate intracranial arterial radius, which is based on modeling and state-estimation techniques. The objective is to obtain a better estimation than that offered by the Lindegaard ratio, that might allow for continuous monitoring and possibly vasospam prediction without the need for angiography. ⋯ Our results indicate that arterial radius may be estimated using measurements of ABP, ICP and CBFV, allowing the detection of vasospasm.
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Acta Neurochir. Suppl. · Jan 2008
Clinical TrialControlled lumbar drainage in medically refractory increased intracranial pressure. A safe and effective treatment.
A prospective study of lumbar CSF drainage in the setting of raised intra-cranial pressure refractory to medical management and ventriculostomy placement is presented. There have been no controlled trials of its use reported in the literature, to the best of our knowledge. ⋯ We have shown that controlled lumbar drainage is a safe, efficacious and minimally invasive method for treatment of elevated ICP refractory to medical management. Ventriculostomies are always placed before utilizing lumbar drains to minimize the risk of cerebral herniation. We would advocate making controlled lumbar drainage a standard part of ICP control protocols.
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Acta Neurochir. Suppl. · Jan 2008
Clinical TrialHyperbaric oxygen therapy for consciousness disturbance following head injury in subacute phase.
Hyperbaric oxygen (HBO) therapy has been shown to improve outcome after brain injury, however its mechanisms are not understood. The purpose of the present study was to investigate the effect of hyperbaric oxygen (HBO) therapy on the cerebral circulation and metabolism of patients with disturbances in consciousness after head injury in the subacute phase. ⋯ The measurement of cerebral circulation and metabolism parameters, especially PI and lac-JV, is useful for estimation of effect of HBO therapy in patients with distubances in consciousness after head injury in the subacute phase.
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Acta Neurochir. Suppl. · Jan 2008
ICM+, a flexible platform for investigations of cerebrospinal dynamics in clinical practice.
ICM+ software encapsulates 20 years of our experience in brain monitoring gained in multiple neurosurgical and intensive care centres. It collects data from a variety of bedside monitors and produces on-line time trends of parameters defined using configurable signal processing formulas. The resulting data can be displayed in a variety of ways including time trends, histograms, cross histograms, correlations, etc. For technically minded researchers there is a plug-in mechanism facilitating registration of third party libraries of functions and analysis tools. ⋯ ICM+ software proved to be useful both academically and clinically. The complexity of data analysis is hidden inside loadable profiles thus allowing clinically minded investigators to take full advantage of signal processing engine in their research into cerebral blood and fluid dynamics.