Acta neurochirurgica. Supplement
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Acta Neurochir. Suppl. · Jan 2012
Intracranial pressure telemetry: first experience of an experimental in vivo study using a new device.
To test two new telemetric intracranial pressure (ICP) probes (NEUROVENT(®)-P-tel, NEUROVENT(®)-S-tel) in a porcine model. We aimed to intraoperatively correlate the telemetric probes to parenchymal ICP probes and study their reliability in the first hours after implantation. The experimental set-up, new telemetric technology and first data will be presented. ⋯ We present a new telemetric technology that was experimentally compared with a parenchymal ICP probe. We provide data that the new telemetric probes will comparably measure ICP vs an external ICP probe. This stand-alone ICP tool may allow permanent measurement of ICP in hydrocephalus patients. Further continuation of our study will demonstrate whether this system guarantees acceptable long-term reliability.
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Acta Neurochir. Suppl. · Jan 2012
Bioinformatics analysis of mortality associated with elevated intracranial pressure in children.
Multivariate data analyses have the potential to enrich the use of the complex plethora of data gathered in the care of critically ill patients. We sought to apply hierarchical cluster analysis to investigate factors affecting outcome in children with acute brain injury requiring ICP monitoring. ⋯ The dose of abnormal ICP may contribute to outcome in insults that involve increased ICP. These results are proof of principle of the potential application of hierarchical clustering to the clinical practice of pediatric neurocritical care.
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Acta Neurochir. Suppl. · Jan 2012
The impact of silver nanoparticle-coated and antibiotic-impregnated external ventricular drainage catheters on the risk of infections: a clinical comparison of 95 patients.
Infection, i.e. meningitis or ventriculitis, is a major complication of external ventricular drainage (EVD). In order to prevent this complication rifampin-impregnated and clindamycin-impregnated silicone catheters and EVDs impregnated with nanoparticles of silver and an insoluble silver salt have been developed. Sparse data are published concerning the efficacy of these catheters in reducing bacterial colonization. ⋯ Rifampin-impregnated and clindamycin-impregnated EVDs as well as silver-impregnated EVDs decreased the infection rate. Randomized studies are needed to assess the advantage of these catheters compared with standard polyurethane catheters.
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Acta Neurochir. Suppl. · Jan 2012
Cerebrospinal fluid lactate concentration after withdrawal of metabolic suppressive therapy in subarachnoid hemorrhage.
Hyperglycolysis is a known phenomenon after severe subarachnoid hemorrhage (SAH) and after brain injury. It is characterized by decreased oxidative metabolism and relatively increased anaerobic glycolysis. Metabolic suppressive therapy reduces the cerebral metabolic rate of oxygen (CMRO(2)) and the cerebral metabolic rate of glucose (CMRGluc). ⋯ In 56% of patients an increase in CSF lactate (mean: 3.2 ± 0.9 mmol/L) after withdrawal of metabolic suppressive therapy was observed. Mean Glasgow Outcome Score (GOS) was lower in patients with an increase in CSF lactate concentration (>0.5 mmol/L) after withdrawal of metabolic suppressive therapy (p = 0.095). In 88% of patients who died during the first 30 days after SAH, a CSF lactate elevation of more than 0.5 mmol/L after withdrawal of metabolic suppressive therapy was found (p = 0.071).
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Acta Neurochir. Suppl. · Jan 2012
Quantification of normal CSF flow through the aqueduct using PC-cine MRI at 3T.
Quantification of cerebrospinal fluid (CSF) flow through the cerebral aqueduct is of paramount importance in patients with hydrocephalus. The purpose of this study was to evaluate the normal CSF flow measurements at three different anatomical levels of the aqueduct utilizing 3-Tesla (3 T) magnetic resonance imaging. ⋯ CSF peak positive velocity, peak negative velocity, and mean flow through the aqueduct were calculated in 22 young healthy volunteers performed at 3 T. Our measurements did not show significant difference compared with the reported measurements obtained at 1.5 T. Slight differences were observed in the CSF hydrodynamic measurements, depending on the anatomical level of the aqueduct; however, they did not vary significantly.