Intracranial Pressure and Intracranial Volume in Children with Craniosynostosis

1993 ◽  
Vol 4 (3) ◽  
pp. 188 ◽  
Author(s):  
D. T. Gault ◽  
D. Renier ◽  
D. Marchac ◽  
B. M. Jones ◽  
Barry L. Eppley
Keyword(s):  
Intracranial Pressure ◽  
Intracranial Volume

Relationship Between Intracranial Pressure and Intracranial Volume in Craniosynostosis

1993 ◽  
Vol 4 (3) ◽  
pp. B1
Author(s):  
H. Fok ◽  
B. M. Jones ◽  
D. G. Gault ◽  
U. Andar ◽  
R. Hayward ◽  
...  
Keyword(s):  
Intracranial Pressure ◽  
Intracranial Volume

scholarly journals Endoscopic assisted suturectomy for primary craniosynostosis in infancy

2018 ◽  
Vol 3 (2) ◽  
Keyword(s):  
Intracranial Pressure ◽  
Minimally Invasive ◽  
Hospital Stay ◽  
Teaching Hospital ◽  
Head Circumference ◽  
Analytical Study ◽  
Intracranial Volume ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Skull Shape

Background: Multiple procedures have been used for the treatment of craniosynostosis, ranging from simple suturectomy to extensive calvarial vault remodeling. The optimal timing for surgery is still controversial. The goal of therapy is to provide adequate intracranial volume, in addition to an aesthetically almost normal skull shape. Endoscopic synostosis repair described in 1998 by Jimenez and Baron [1]. This technique allows for a less invasive method that can result in excellent longstanding reconstruction of the cranial skeleton. This method is a minimally invasive approach that has less morbidity involved with traditional reconstruction techniques. Aim: Evaluation of early endoscopic suturectomy and its impact on both neurological functions and cosmetic appearance of infants up to 6 months of age suffering primary craniosynostosis. Methodology: This is a prospective analytical study of 50 patients with primary non syndromic craniosynostosis either single suture or multiple sutures, up to sixth months of age; with evident of skull shape deformity and or manifestations of increase intracranial pressure. from; October 2009 to October 2016 were managed byendoscopic assisted suturectomy the approach of Jimenez and Baron, in both Neurosurgery Department Shebin Elkom teaching hospital and Neurosurgery Department in Elsahel teaching hospital. Clinical and radiological follow up for six months postoperative. Results: This is a prospective analytical study of 50 patients with primary craniosynostosis, 28 patients are male and 22 patients are female. The age of patients range from one and half months to sixth months. The majority of cases presented with deformity alone 68%. Other clinical presentations as manifestations of increased intracranial pressure, fits, and delayed milestones plus deformity was 20%, 8%, and 4% respectively. Estimated blood loss, the mean loss was 56cc, minimum 30cc, and maximum was 100cc, with stander deviation ±18cc.The minimum hospital stay was one day and maximum was three days.There is significant change of head shape and head circumference postoperatively this observed by highly significant P value in head circumference (< 0.001). Conclusion: Endoscopic assisted suturectomy is minimally invasive approach with a very narrow range of complications, very limited need to blood transfusion and if it occurs, it is small volume in relation to total volume. Very short ICU and hospital stay also decrease the economic load.

Management of raised intracranial pressure

2020 ◽  
pp. 3892-3897
Author(s):  
David K. Menon
Keyword(s):  
Intracranial Pressure ◽  
Cerebral Perfusion Pressure ◽  
Cerebral Perfusion ◽  
Brain Oedema ◽  
Cerebral Blood Volume ◽  
Perfusion Pressure ◽  
Brain Perfusion ◽  
Normal Brain ◽  
Intracranial Volume ◽  
Nervous System Diseases

Normal intracranial pressure is between 5 and 15 mm Hg in supine subjects. Intracranial hypertension (ICP >20 mm Hg) is common in many central nervous system diseases and in fatal cases is often the immediate cause of death. Increases in intracranial volume and hence—given the rigid skull—intracranial pressure may be the consequence of brain oedema, increased cerebral blood volume, hydrocephalus, and space-occupying lesions. Brain perfusion depends on the cerebral perfusion pressure which is mean arterial pressure minus intracranial pressure. The normal brain autoregulates cerebral blood flow down to a lower limit of cerebral perfusion pressure of about 50 mm Hg in healthy subjects, and perhaps 60–70 mm Hg in disease. Cerebral perfusion pressure reduction to below these values results in cerebral ischaemia.

Intracranial volume versus static and pulsatile intracranial pressure values in children with craniosynostosis

2019 ◽  
Vol 24 (1) ◽  
pp. 66-74 ◽  
Author(s):  
Erlend Aambø Langvatn ◽  
Radek Frič ◽  
Bernt J. Due-Tønnessen ◽  
Per Kristian Eide
Keyword(s):  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Brain Tissue ◽  
Wave Amplitude ◽  
Cranial Vault ◽  
Intracranial Volume ◽  
Raised Intracranial Pressure ◽  
Pathophysiological Mechanisms ◽  
Patient Cohort ◽  
Before And After

OBJECTIVEReduced intracranial volume (ICV) and raised intracranial pressure (ICP) are assumed to be principal pathophysiological mechanisms in childhood craniosynostosis. This study examined the association between ICV and ICP and whether ICV can be used to estimate the ICP.METHODSThe authors analyzed ICV and ICP measurements from children with craniosynostosis without concurrent hydrocephalus and from age-matched individuals without craniosynostosis who underwent diagnostic ICP measurement.RESULTSThe study included 19 children with craniosynostosis (mean age 2.2 ± 1.9 years) and 12 reference individuals without craniosynostosis (mean age 2.5 ± 1.6 years). There was no difference in ICV between the patient and reference cohorts. Both mean ICP (17.1 ± 5.6 mm Hg) and mean wave amplitude (5.9 ± 2.6 mm Hg) were higher in the patient cohort. The results disclosed no significant association between ICV and ICP values in the patient or reference cohorts, and no association was seen between change in ICV and ICP values after cranial vault expansion surgery (CVES) in 5 children in whom ICV and ICP were measured before and after CVES.CONCLUSIONSIn this cohort of children with craniosynostosis, there was no significant association between ICV and ICP values prior to CVES and no significant association between change in ICV and ICP values after CVES in a subset of patients. Therefore, ICV could not reliably estimate the ICP values. The authors suggest that intracranial hypertension in childhood craniosynostosis may not be caused by reduced ICV alone but rather by a distorted relationship between ICV and the volume of intracranial content (brain tissue, CSF, and blood).

scholarly journals Intracranial compliance during the post-operative period after surgery for intracranial aneurysms

1979 ◽  
Vol 37 (3) ◽  
pp. 250-254
Author(s):  
Hildo R. C de Azevedo Filho ◽  
Christopher B. T. Adams ◽  
John Kerr
Keyword(s):  
Intracranial Pressure ◽  
Cerebral Vasospasm ◽  
Intracranial Aneurysms ◽  
Continuous Monitoring ◽  
Pressure Increase ◽  
Intracranial Volume ◽  
Operative Results ◽  
Intracranial Compliance ◽  
Post Operative Period ◽  
Ruptured Intracranial Aneurysms

Generalised post-operative cerebral vasospasm is a major factor in delineating poor operative results following direct ruptured intracranial aneurysms. Continuous monitoring of intracranial pressure seems to be particularly helpful on such occasions, and intracranial compliance determination as well. High intracranial compliance values suggest that even small intracranial volume increases may induce rapid intracranial pressure increase and situations likely to produce neurological deterioration.

scholarly journals Cortical Pressure Injury: A Hypothesis to Explain the Incongruity of Clinical and Radiologic Improvement in Decompressive Craniectomy

2019 ◽  
Vol 08 (03) ◽  
pp. 188-190
Author(s):  
Sudip Kumar Sengupta ◽  
Harjinder Singh Bhatoe
Keyword(s):  
Intracranial Pressure ◽  
Clinical Outcome ◽  
Decompressive Craniectomy ◽  
Cranial Vault ◽  
Intracranial Volume ◽  
Anatomy And Physiology ◽  
Pressure Injury ◽  
The Brain ◽  
Shared Problem

AbstractIt has astonished neuroscientists since the advent of decompressive craniectomy as to why a seemingly successfully achieved goal of reduction in intracranial pressure (ICP), by removing a portion of the cranial vault and the resultant intracranial volume augmentation, fails to give the desired beneficial clinical outcome in every case and in fact, at times, proves to be deleterious in some conditions with a shared problem of refractory raised ICP. The authors propose a hypothesis based on the understanding of the anatomy and physiology of the brain that can explain the fallacy.

A rabbit model of human familial, nonsyndromic unicoronal suture synostosis II. Intracranial contents, intracranial volume, and intracranial pressure

1998 ◽  
Vol 14 (6) ◽  
pp. 247-255 ◽  
Author(s):  
M. P. Mooney ◽  
Michael I. Siegel ◽  
Annie M. Burrows ◽  
Timothy D. Smith ◽  
H. Wolfgang Losken ◽  
...  
Keyword(s):  
Intracranial Pressure ◽  
Rabbit Model ◽  
Intracranial Volume

scholarly journals Methylprednisolone Modulates Intracranial Pressure in the Brain Cellular Edema Induced by Water Intoxication

2017 ◽  
pp. S511-S516 ◽  
Author(s):  
P. KOZLER ◽  
D. MAREŠOVÁ ◽  
J. POKORNÝ
Keyword(s):  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Brain Edema ◽  
Continuous Monitoring ◽  
Water Intoxication ◽  
Pressure Increase ◽  
Intracranial Volume ◽  
Pressure Transmitter ◽  
The Brain

Continuous monitoring of the intracranial pressure (ICP) detects impending intracranial hypertension resulting from the impaired intracranial volume homeostasis, when expanding volume generates pressure increase. In this study, cellular brain edema (CE) was induced in rats by water intoxication (WI). Methylprednisolone (MP) was administered intraperitoneally (i.p.) before the start of CE induction, during the induction and after the induction. ICP was monitored for 60 min within 20 h after the completion of the CE induction by fibreoptic pressure transmitter. In rats with induced CE, ICP was increased (MeanSEM: 14.25±2.12) as well as in rats with MP administration before the start of CE induction (10.55±1.27). In control rats without CE induction (4.62±0.24) as well as in rats with MP applied during CE induction (5.52±1.32) and in rats with MP applied after the end of CE induction (6.23±0.73) ICP was normal. In the last two groups of rats, though the CE was induced, intracranial volume homeostasis was not impaired, intracranial volume as well as ICP were not increased. It is possible to conclude that methylprednisolone significantly influenced intracranial homeostasis and thus also the ICP values in the model of cellular brain edema.

scholarly journals Cardiac-gated intracranial elastance in a swine model of raised intracranial pressure: a novel method to assess intracranial pressure–volume dynamics

2020 ◽  
pp. 1-8
Author(s):  
Omer Doron ◽  
Ofer Barnea ◽  
Nino Stocchetti ◽  
Tal Or ◽  
Erez Nossek ◽  
...  
Keyword(s):  
Intracranial Pressure ◽  
Cerebral Edema ◽  
Cardiac Cycle ◽  
Large Animal Model ◽  
Swine Model ◽  
Large Animal ◽  
Intracranial Volume ◽  
Early Systole ◽  
Patients At Risk ◽  
Injured Patients

OBJECTIVEPrevious studies have demonstrated the importance of intracranial elastance; however, methodological difficulties have limited widespread clinical use. Measuring elastance may offer potential benefit in helping to identify patients at risk for untoward intracranial pressure (ICP) elevation from small rises in intracranial volume. The authors sought to develop an easily used method that accounts for the changing ICP that occurs over a cardiac cycle and to assess this method in a large-animal model over a broad range of ICPs.METHODSThe authors used their previously described cardiac-gated intracranial balloon pump and swine model of cerebral edema. In the present experiment they measured elastance at 4 points along the cardiac cycle—early systole, peak systole, mid-diastole, and end diastole—by using rapid balloon inflation to 1 ml over an ICP range of 10–30 mm Hg.RESULTSThe authors studied 7 swine with increasing cerebral edema. Intracranial elastance rose progressively with increasing ICP. Peak-systolic and end-diastolic elastance demonstrated the most consistent rise in elastance as ICP increased. Cardiac-gated elastance measurements had markedly lower variance within swine compared with non–cardiac-gated measures. The slope of the ICP–elastance curve differed between swine. At ICP between 20 and 25 mm Hg, elastance varied between 8.7 and 15.8 mm Hg/ml, indicating that ICP alone cannot accurately predict intracranial elastance.CONCLUSIONSMeasuring intracranial elastance in a cardiac-gated manner is feasible and may offer an improved precision of measure. The authors’ preliminary data suggest that because elastance values may vary at similar ICP levels, ICP alone may not necessarily best reflect the state of intracranial volume reserve capacity. Paired ICP–elastance measurements may offer benefit as an adjunct “early warning monitor” alerting to the risk of untoward ICP elevation in brain-injured patients that is induced by small increases in intracranial volume.

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