Acta neurochirurgica. Supplement
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Acta Neurochir. Suppl. · Jan 2008
The relationship between intracranial pressure and brain oxygenation following traumatic brain injury in sheep.
While it is understood that raised intracranial pressure (ICP) after traumatic brain injury (TBI) may negatively impact on brain tissue oxygenation (PbtO2), few studies have characterized the inter-relationship between these two variables, particularly in a large animal model that replicates the human gyrencephalic brain. The current study uses an ovine model to examine the dynamics of ICP and PbtO2 after TBI. ⋯ Our results suggest that TBI results in early changes in ICP that are associated with profound declines in PbtO2, and may indicate the need for earlier management of ICP after TBI.
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Acta Neurochir. Suppl. · Jan 2008
Increased levels of CSF heart-type fatty acid-binding protein and tau protein after aneurysmal subarachnoid hemorrhage.
Heart-type Fatty Acid-Binding Protein (H-FABP) and tau protein (tau) have been shown to be novel biomarkers associated with brain injury and, therefore, they could represent a useful diagnostic tool in patients with subarachnoid hemorrhage (SAH). The goal of this study was to measure H-FABP and tau in cerebrospinal fluid (CSF) following SAH to test the hypothesis that a relationship exists between SAH severity and H-FABP/tau values. ⋯ H-FABP and tau CSF levels are proportional to SAH severity and may be novel biomarkers that can be used to predict the severity of outcome following clinical SAH.
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Acta Neurochir. Suppl. · Jan 2008
Low frequency pressure waves of possible autonomic origin in severely head-injured children.
Useful information (both clinical and pathophysiological) which may be extracted from intracranial pressure (ICP) recordings include: (1) the mean level of ICP (and CPP), (2) cerebrovascular autoregulation status, (3) the intracranial pulse pressure (the pulse wave index, ICPpp/ICPm) or the pressure-volume compensatory reserve index (RAP) and (4) the presence of any abnormal ICP waveform. This paper describes a slow frequency ICP waveform in children with TBI and postulates the pathophysiological basis and whether it contains clinically useful detail. ⋯ We postulate that these previously unreported slow waveforms may reflect the very low frequency (VLF) and ultra low frequency (ULF; < or = 1 per 5 min) components of heart rate and arterial blood pressure variability.
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Acta Neurochir. Suppl. · Jan 2008
Effect of increased intracranial pressure on cerebral vasospasm in SAH.
Increased ICP is common and might precipitate cerebral vasospasm (VSP)-induced ischemic events in aneurysmal SAH (ASAH).Our objective was to determine if there is an association between increased ICP and transcranial colour coded Doppler-angiographic VSP (TCCD-A VSP) in relation to delayed neurological deficit (DND) and poor outcome. ⋯ Increased ICP, not decreased CPP, was related to VSP. The combination of TCCD-A VSP and increased ICP was predictive of poor outcome. Management of acute ASAH should include reduction of increased ICP especially when there is concomitant TCCD-A VSP.
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Acta Neurochir. Suppl. · Jan 2008
Neurological deficits and brain edema after intracerebral hemorrhage in Mongolian gerbils.
We examined the time course of neurological deficits in gerbils after an intracerebral hemorrhage (ICH) induced by autologous blood infusion and examined its correlation with the severity of perihematomal edema. Mongolian gerbils (n = 15) were subjected to stereotaxic autologous blood infusion (30 or 60 microL) into the left caudate nucleus. Corner-turn and forelimb-placing tests were performed before, and 1 and 3 days after ICH. ⋯ Both neurological deficits and perihematomal edema were significantly greater in animals with 60 microL blood infusion compared to the 30 microL infusion group, and both neurological deficits and edema were also greater at 3 days compared to 1 day after ICH. The severity of neurological deficits paralleled the degree of perihematomal edema. We conclude that the Mongolian gerbil is a suitable model for studies on the behavioral effects of ICH.