Acta neurochirurgica. Supplement
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Acta Neurochir. Suppl. · Jan 2005
Clinical TrialImprovement of brain tissue oxygen and intracranial pressure during and after surgical decompression for diffuse brain oedema and space occupying infarction.
We evaluated the perioperative and intraoperative changes of intracranial pressure (ICP) and partial pressure of brain tissue oxygen (PtiO2) after decompressive craniectomy in patients with diffuse brain oedema and space occupying infarction. ⋯ Decompressive craniectomy seems to be a successful option in the treatment of intractable intracranial hypertension with associated cerebral hypoxia. These positive effects may last for several hours after the procedure irrespective of the underlying disease.
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Acta Neurochir. Suppl. · Jan 2005
Clinical TrialPrediction of cerebral blood flow restoration after extracranial-intracranial bypass surgery using superficial temporal artery duplex ultrasonography (STDU).
We investigated the availability of superficial temporal artery (STA) duplex ultrasonography (STDU) for evaluating the improvement of cerebral hemodynamics after extracranial-intracranial (EC-IC) bypass. This study included 56 consecutive patients who underwent EC-IC bypass for occlusive disease of their cerebral arteries. STA duplex ultrasonography (STDU) was performed to measure the flow velocity, pulsatility index, and diameter of ipsilateral STA before and 14 days after EC-IC bypass. ⋯ STA mean flow velocity was significantly correlated with the rCBF 14 days after EC-IC bypass (R = 0.55, p < 0.0001). The post-surgical STA mean flow velocity cut-off value over 58.2 cm/sec yielded the highest diagnostic accuracy (sensitivity, 75%; specificity, 74%) for excellent rCBF value (> or =40 ml/100 g/min) after EC-IC bypass. The ipsilateral STA mean blood flow velocity is a highly sensitive parameter for predicting rCBF in the ipsilateral MCA territory after EC-IC bypass.
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Acta Neurochir. Suppl. · Jan 2005
Endovascular treatment of cerebral vasospasm following aneurysmal subarachnoid hemorrhage.
Endovascular treatment by balloon angioplasty or intra-arterial papaverine infusion has been established as a valuable treatment option in patients with cerebral vasospasm refractory to maximal medical therapy. A summary of the indications, applications and limitations is provided for microcatheter guided selective papaverine infusion and transluminal balloon angioplasty in patients who sustain cerebral vasospasm following subarachnoid haemorrhage. Structured neuro-intensive and endovascular treatment of imminent vasospasm integrate papaverine administration and balloon angioplasty as complimentary rather than alternative techniques.
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An open collaborative international network has been established which aims to improve inter-centre standards for collection of high-resolution, neurointensive care data on patients with traumatic brain injury. The group is also working towards the creation of an open access, detailed and validated database that will be useful for hypothesis generation. In Part A, we describe the underlying concept of the group and it's aims and in Part B we describe the current status of the groups development. ⋯ The BrainIT network provides a more standardised and higher resolution data collection mechanism for research groups, organisations and the device industry to conduct multicentre trials of new health care technology in patients with traumatic brain injury.
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Acta Neurochir. Suppl. · Jan 2005
Survey of traumatic brain injury management in European Brain-IT centres year 2001.
The aim of this study was to obtain basic knowledge about the current local conditions and neurointensive care of traumatic brain injury (TBI) in the new multi-centre collaborative BrainIT group. ⋯ There seemed to be an agreement on neurointensive care policies within the BrainIT group. The suggested order of treatment was generally in accordance with published guidelines although the suggested order and combinations of different treatments varied. Variation of treatment within the range of prescribed standards provides optimal conditions for an interesting future analysis of treatment and monitoring data in reality using the BrainIT database.