Early discovery of a traumatic carotid-cavernous sinus fistula by jugular venous oxygen saturation monitoring

1995 ◽  
Vol 83 (5) ◽  
pp. 910-911 ◽  
Author(s):  
Barthélémy Calon ◽  
Guy Freys ◽  
Anne Launoy ◽  
Patrick Boyer ◽  
Jean Tongio ◽  
...  
Keyword(s):  
Head Injury ◽  
Oxygen Saturation ◽  
Cavernous Sinus ◽  
Severe Head Injury ◽  
Content Type ◽  
Jugular Venous Oxygen Saturation ◽  
Venous Oxygen Saturation ◽  
Carotid Cavernous Sinus Fistula ◽  
Acute Increase ◽  
Fine Print

✓ This report describes the early diagnosis, due to an acute increase of jugular venous oxygen saturation occurring 20 hours after trauma, of a traumatic carotid-cavernous sinus fistula after severe head injury. Hyperemia in severe head injury should be treated only after an intracerebral arteriovenous communication has been excluded.

Elevated jugular venous oxygen saturation after severe head injury

1999 ◽  
Vol 90 (1) ◽  
pp. 9-15 ◽  
Author(s):  
Manuela Cormio ◽  
Alex B. Valadka ◽  
Claudia S. Robertson
Keyword(s):  
Head Injury ◽  
Oxygen Saturation ◽  
Severe Head Injury ◽  
Persistent Vegetative State ◽  
Content Type ◽  
Jugular Venous Oxygen Saturation ◽  
Group I ◽  
Venous Oxygen Saturation ◽  
Group Ii ◽  
Fine Print

Object. The aim of this study was to investigate the incidence of elevated (≥ 75%) jugular venous oxygen saturation (SjvO2) and its relationship to cerebral hemodynamic and metabolic parameters and to outcome after severe head injury.Methods. Data from 450 severely head injured patients admitted to the Neurosurgical Intensive Care Unit of Ben Taub General Hospital were analyzed retrospectively. The SjvO2 was measured in blood obtained from indwelling jugular bulb catheters. Patients were classified into the following categories: high (Group I), normal (Group II), or low SjvO2 (Group III) if their mean SjvO2 over the duration of monitoring was 75% or higher, 74 to 56%, or 55% or lower, respectively.A high SjvO2 occurred in 19.1% of patients. There was no consistent relationship between SjvO2 and simultaneous cerebral blood flow (CBF) or cerebral perfusion pressure measurements. Compared with Groups II and III, the patients in Group I had a significantly higher CBF and lower cerebral metabolic rate of oxygen (CMRO2). In Group I, the outcomes were death or persistent vegetative state in 48.8% of patients and severe disability in 25.6%. These outcomes were significantly worse than for patients in Group II. Within Group I, the patients with a poor neurological outcome were older and more likely to have suffered a focal head injury; they demonstrated a lower CMRO2 and a greater rate of cerebral lactate production than the patients who attained a favorable outcome.Conclusions. Posttraumatic elevation of SjvO2 is common but cannot be automatically equated with hyperemia. Instead, elevated SjvO2 is a heterogeneous condition that is associated with poor outcome after head injury and may carry important implications for the management of comatose patients.

Carotid-cavernous sinus fistula presenting as a posterior fossa mass

1975 ◽  
Vol 42 (5) ◽  
pp. 585-588 ◽  
Author(s):  
Bruce Bartlow ◽  
Richard D. Penn
Keyword(s):  
Hearing Loss ◽  
Head Injury ◽  
Trigeminal Neuralgia ◽  
Posterior Fossa ◽  
Cavernous Sinus ◽  
Severe Head Injury ◽  
Content Type ◽  
Carotid Cavernous Sinus Fistula ◽  
Fine Print

✓ The authors report a case in which trigeminal neuralgia and hearing loss developed 14 years after a severe head injury. Arteriography demonstrated a carotid-cavernous sinus fistula producing a large venous mass in the posterior fossa.

scholarly journals Elevated jugular venous oxygen saturation after severe head injury

2001 ◽  
Vol 11 (4) ◽  
pp. 9-15 ◽  
Author(s):  
Manuela Cormio ◽  
Alex B. Valadka ◽  
Claudia S. Robertson
Keyword(s):  
Head Injury ◽  
Oxygen Saturation ◽  
Severe Head Injury ◽  
Vegetative State ◽  
Persistent Vegetative State ◽  
Lactate Production ◽  
Jugular Venous Oxygen Saturation ◽  
Group I ◽  
Venous Oxygen Saturation ◽  
Group Ii

Object The aim of this study was to investigate the incidence of elevated (≥ 75%) jugular venous oxygen saturation (SjvO2) and its relationship to cerebral hemodynamic and metabolic parameters and to outcome after severe head injury. Methods Data from 450 severely head injured patients admitted to the Neurosurgical Intensive Care Unit of Ben Taub General Hospital were analyzed retrospectively. The SjvO2 was measured in blood obtained from indwelling jugular bulb catheters. Patients were classified into the following categories: high (Group I), normal (Group II), or low SjvO2 (Group III) if their mean SjvO2 over the duration of monitoring was 75% or higher, 74 to 56%, or 55% or lower, respectively. A high SjvO2 occurred in 19.1% of patients. There was no consistent relationship between SjvO2 and simultaneous cerebral blood flow (CBF) or cerebral perfusion pressure measurements. Compared with Groups II and III, the patients in Group I had a significantly higher CBF and lower cerebral metabolic rate of oxygen (CMRO2). In Group I, the out- comes were death or persistent vegetative state in 48.8% of patients and severe disability in 25.6%. These outcomes were significantly worse than for patients in Group II. Within Group I, the patients with a poor neurological outcome were older and more likely to have suffered a focal head injury; they demonstrated a lower CMRO2 and a greater rate of cerebral lactate production than the patients who attained a favorable outcome. Conclusions Posttraumatic elevation of SjvO2 is common but cannot be automatically equated with hyperemia. Instead, elevated SjvO2 is a heterogeneous condition that is associated with poor outcome after head injury and may carry important implications for the management of comatose patients.

A clinical comparison of subdural screw pressure measurements with ventricular pressure

1983 ◽  
Vol 58 (1) ◽  
pp. 45-50 ◽  
Author(s):  
A. David Mendelow ◽  
John O. Rowan ◽  
Lilian Murray ◽  
Audrey E. Kerr
Keyword(s):  
Head Injury ◽  
Intracranial Pressure ◽  
Severe Head Injury ◽  
Fluid Pressure ◽  
Ventricular Catheter ◽  
Pressure Measurements ◽  
Content Type ◽  
Single Lumen ◽  
Ventricular Fluid Pressure ◽  
Fine Print

✓ Simultaneous recordings of intracranial pressure (ICP) from a single-lumen subdural screw and a ventricular catheter were compared in 10 patients with severe head injury. Forty-one percent of the readings corresponded within the same 10 mm Hg ranges, while 13% of the screw pressure measurements were higher and 46% were lower than the associated ventricular catheter measurements. In 10 other patients, also with severe head injury, pressure measurements obtained with the Leeds-type screw were similarly compared with ventricular fluid pressure. Fifty-eight percent of the dual pressure readings corresponded, while 15% of the screw measurements were higher and 27% were lower than the ventricular fluid pressure, within 10-mm Hg ranges. It is concluded that subdural screws may give unreliable results, particularly by underestimating the occurrence of high ICP.

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