Effects of mannitol and steroid therapy on intracranial volume-pressure relationships in patients

1975 ◽  
Vol 42 (3) ◽  
pp. 274-281 ◽  
Author(s):  
J. Douglas Miller ◽  
Peter Leech
Keyword(s):  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Continuous Monitoring ◽  
Pressure Response ◽  
Pressure Curve ◽  
Intracranial Volume ◽  
Intraventricular Pressure ◽  
Content Type ◽  
Spatial Compensation ◽  
Fine Print

✓ The intracranial volume-pressure response was measured in 61 patients undergoing continuous monitoring of intraventricular pressure. This test, which determines the increase in intracranial pressure induced by an addition of 1 ml in ventricular CSF volume in 1 second, yields information concerning spatial compensation in patients with intracranial space-occupying processes. On the basis of variability tests, a change in volume-pressure response of 2 mm Hg/ml was accepted as significant. Pronounced enlargement of the ventricles interferes with the test. In patients with intracranial hypertension, intravenous mannitol (0.5 gm/kg) and intramuscular betamethasone (26 mg) both reduce the volume-pressure response significantly more than they reduce intracranial pressure. This suggests that these agents favorably alter the configuration of the volume-pressure curve.

Intracranial volume-pressure relationship in man

1982 ◽  
Vol 56 (4) ◽  
pp. 524-528 ◽  
Author(s):  
Joseph Th. J. Tans ◽  
Dick C. J. Poortvliet
Keyword(s):  
Best Approximation ◽  
Continuous Monitoring ◽  
Fluid Pressure ◽  
Constant Term ◽  
Volume Index ◽  
Intracranial Volume ◽  
Content Type ◽  
The Best Approximation ◽  
Ventricular Fluid Pressure ◽  
Fine Print

✓ The pressure-volume index (PVI) was determined in 40 patients who underwent continuous monitoring of ventricular fluid pressure. The PVI value was calculated using different mathematical models. From the differences between these values, it is concluded that a monoexponential relationship with a constant term provides the best approximation of the PVI.

Intracranial pressure responses to alterations in arterial carbon dioxide pressure in patients with head injuries

1972 ◽  
Vol 36 (6) ◽  
pp. 714-720 ◽  
Author(s):  
Ronald L. Paul ◽  
Octavio Polanco ◽  
Stephen Z. Turney ◽  
T. Crawford McAslan ◽  
R. Adams Cowley
Keyword(s):  
Carbon Dioxide ◽  
Intracranial Pressure ◽  
Head Injuries ◽  
Intraventricular Pressure ◽  
Content Type ◽  
Arterial Carbon Dioxide ◽  
Cerebral Vasomotor Reactivity ◽  
Carbon Dioxide Pressure ◽  
Pressure Changes ◽  
Fine Print

✓ Cerebral vasomotor responses to alterations in arterial carbon dioxide (PaCO2), as manifested by intraventricular pressure changes, were studied in a group of patients with head injuries. These patients could be classified into three types based on various degrees of responsiveness thought to reflect the integrity of their cerebral vasomotor reactivity.

Effects of intravenous nitroglycerin on the intracranial pressure and volume pressure response

1983 ◽  
Vol 58 (4) ◽  
pp. 562-565 ◽  
Author(s):  
Ghaleb A. Ghani ◽  
Yung Fong Sung ◽  
Michael S. Weinstein ◽  
George T. Tindall ◽  
Alan S. Fleischer
Keyword(s):  
Blood Pressure ◽  
Intracranial Pressure ◽  
Fluid Pressure ◽  
Pressure Response ◽  
Mean Blood Pressure ◽  
Intravenous Nitroglycerin ◽  
Content Type ◽  
Ventricular Fluid Pressure ◽  
The Mean ◽  
Fine Print

✓ Ventricular fluid pressure (VFP) and volume-pressure response were measured during nitroglycerin (NTG) infusion in nine patients anesthetized with N2O and fentanyl. The patients' ventilation was controlled, and PaCO2 was kept at 32 ± 4 mm Hg. When an infusion of 0.01% NTG was given intravenously to decrease the mean blood pressure to 95.1%, 84.7%, and 78.2% of control, the VFP increased from control levels of 9.94 ± 2.14 mm Hg to 12.89 ± 2.25, 15.6 ± 2.85, and 14.43 ± 3.45 mm Hg, respectively. The volume-pressure response showed a significant increase when blood pressure decreased to 84.7% and 78.2% of control. These results suggest that intravenous NTG caused an increase in the intracranial pressure and a decrease in the intracranial compliance.

Intracranial volume-pressure relationship in man

1983 ◽  
Vol 59 (5) ◽  
pp. 810-816 ◽  
Author(s):  
Joseph Th. J. Tans ◽  
Dick C. J. Poortvliet
Keyword(s):  
Continuous Monitoring ◽  
Fluid Pressure ◽  
Pressure Rise ◽  
Intracranial Volume ◽  
Content Type ◽  
Intensive Monitoring ◽  
Therapeutic Consequences ◽  
Ventricular Fluid Pressure ◽  
The Relationship ◽  
Fine Print

✓ Pressure-volume indices (PVI's) were determined for a heterogeneous group of 40 patients who underwent continuous monitoring of ventricular fluid pressure (VFP). The main purpose was to investigate the relationship between VFP and PVI and to establish the significance of the measured PVI values. Determinations of PVI appear to be useful only when baseline VFP is under 20 mm Hg, maximum VFP is under 30 mm Hg, A-waves are absent, and B-waves do not occur numerously. The authors advocate starting with 1-ml bolus infusions, and then, when the resulting pressure rise exceeds 4 mm Hg, additional bolus infusions can be omitted. Results indicate that 13 ml and 10 ml are the key values for the PVI. A PVI of less than 13 ml indicates the need for either reduction of VFP and improvement of compliance or intensive monitoring of both the VFP and the volume-pressure relationship; if the PVI is below 10 ml, anti-hypertensive treatment is almost always necessary. Values of PVI's between 13 and 18 ml, although pathological, usually have no therapeutic consequences.

Is the placement of shunts in patients with idiopathic normal pressure hydrocephalus worth the risk? Results of a study based on continuous monitoring of intracranial pressure

2004 ◽  
Vol 100 (5) ◽  
pp. 855-866 ◽  
Author(s):  
Maria A. Poca ◽  
Maria Mataró ◽  
Maria Del Mar Matarín ◽  
Fuat Arikan ◽  
Carmen Junqué ◽  
...  
Keyword(s):  
Intracranial Pressure ◽  
Normal Pressure Hydrocephalus ◽  
Continuous Monitoring ◽  
Normal Pressure ◽  
Idiopathic Normal Pressure Hydrocephalus ◽  
Symptom Duration ◽  
High Morbidity ◽  
Shunt Insertion ◽  
Content Type ◽  
Fine Print

Object. Data from many studies have demonstrated that shunt insertion in patients with idiopathic normal-pressure hydrocephalus (NPH) is associated with high morbidity and a lack of significant improvement; however, the use of strict diagnostic and treatment protocols can improve the results of surgery in these patients. The primary aim in this prospective study was to analyze the results of shunt placement in 43 patients with idiopathic NPH. A secondary aim was to determine the relationship between several clinical and neuroimaging factors, and patient outcome after surgery. Methods. Thirty men and 13 women with a mean age of 71.1 ± 6.9 years participated in this study. All patients underwent clinical, neuropsychological, and radiological assessment before and 6 months after surgery. In all patients continuous monitoring of intracranial pressure was performed using a fiberoptic extradural sensor. In 31 patients cerebrospinal fluid dynamics were also determined. Eighty-six percent of patients showed clinical improvement after shunt insertion, 11.6% showed no change, and 2.3% exhibited some worsening. Gait improved in 81.4% of the patients, sphincter control in 69.8%, and cognitive dysfunction in 39.5%. There was no treatment-related death. Early or late postsurgical complications occurred in six patients (14%), although all of these complications were minor or were satisfactorily resolved. The complete clinical triad, cortical sulci size, and periventricular lucencies were related to outcome, whereas patient age, symptom duration, ventricular dilation, and the degree of presurgical dementia were unrelated to outcome. Conclusions. Given the correct diagnosis, shunt insertion can produce marked improvement in patients with idiopathic NPH syndrome, causing few deaths and few clinically relevant complications.

Alteration of circadian temperature rhythm with third ventricular obstruction

1973 ◽  
Vol 38 (3) ◽  
pp. 309-319 ◽  
Author(s):  
Robert B. Page ◽  
Joseph H. Galicich ◽  
Jerome A. Grunt
Keyword(s):  
Intracranial Pressure ◽  
Body Temperature ◽  
Elevated Pressure ◽  
Endocrine Function ◽  
Intraventricular Pressure ◽  
Shunt System ◽  
Content Type ◽  
Temperature Rhythm ◽  
Fine Print

✓ Body temperature and endocrine function were studied in three hydrocephalic patients with tumors in the region of the hypothalamus. A circadian temperature rhythm was present under normal intraventricular pressure but was upset during elevated pressure. The results suggest that the absence of a circadian temperature rhythm in patients with third ventricular neoplasms indicates ventricular obstruction with consequent intracranial pressure and/or hydrocephalus. Conversely, the presence of a circadian temperature rhythm indicates that ventricular obstruction has not occurred or that a shunt system placed to bypass such an obstruction is functioning.

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.

Intracranial pressure in patients with dementia and communicating hydrocephalus

1974 ◽  
Vol 40 (3) ◽  
pp. 376-380 ◽  
Author(s):  
Jagdish C. Chawla ◽  
A. Hulme ◽  
R. Cooper
Keyword(s):  
Intracranial Pressure ◽  
Continuous Monitoring ◽  
Communicating Hydrocephalus ◽  
Content Type ◽  
Fine Print

✓ Intracranial pressure (ICP) was monitored continuously for 48 to 72 hours in 12 patients with dementia and communicating hydrocephalus, to see if this would help determine which patients might benefit from surgical shunting of CSF, since not all such patients respond to treatment. Patients who showed variability of ICP improved following surgery, while patients with consistently flat ICP tracings did not. It is suggested that continuous monitoring of ICP may help identify cases suitable for surgery.

Experimental intracranial hypertension due to vascular blockade

1970 ◽  
Vol 33 (2) ◽  
pp. 156-166 ◽  
Author(s):  
J. Donald McQueen ◽  
Lawrence F. Jelsma ◽  
Fernando Bacci ◽  
Isauro Pereira
Keyword(s):  
Blood Pressure ◽  
Cerebrospinal Fluid ◽  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Cerebral Edema ◽  
Content Type ◽  
Vascular Bed ◽  
Pressor Responses ◽  
Pressure Transmission ◽  
Fine Print

✓ High intracranial hypertension was induced in dogs by intracarotid injections of oil. Cerebrospinal fluid pressures continued to rise as Cushing pressor responses were evoked, but were not exceeded by the blood pressure. Transmission of blood pressure through a dilated vascular bed has been suggested as the mechanism. There was no correlation between levels of cerebral edema and the rise in intracranial pressure. This increase in pressure due to vascular blockade has been differentiated from that caused by subarachnoid blockade.

Variations of intraventricular pressure during pneumoencephalography

1974 ◽  
Vol 40 (1) ◽  
pp. 101-106 ◽  
Author(s):  
Jacques Philippon ◽  
Bernard George ◽  
Jean Metzger
Keyword(s):  
Cerebrospinal Fluid ◽  
Intracranial Hypertension ◽  
Normal Pressure Hydrocephalus ◽  
Initial Pressure ◽  
Normal Pressure ◽  
Intraventricular Pressure ◽  
Csf Dynamics ◽  
Content Type ◽  
Fine Print

✓ Intraventricular pressure was studied in eight patients during and after diagnostic pneumoencephalography. In cases with normal initial pressure and normal cerebrospinal fluid (CSF) dynamics, variations in pressure were moderate, immediate, and disappeared at the end of the examination. In cases of normal-pressure hydrocephalus, there was a slow but relatively important elevation that continued for at least 24 hours. In cases with intracranial hypertension, there was a rapid significant increase; return to normal depended principally upon the flow from a large CSF compartment.

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