Regional brain tissue pressure gradients created by expanding extradural temporal mass lesion

1997 ◽  
Vol 86 (3) ◽  
pp. 505-510 ◽  
Author(s):  
Christopher E. Wolfla ◽  
Thomas G. Luerssen ◽  
Robin M. Bowman
Keyword(s):  
Intracranial Pressure ◽  
Frontal Lobe ◽  
Brain Tissue ◽  
Temporal Lobe ◽  
Mass Lesion ◽  
Pressure Monitor ◽  
Tissue Pressure ◽  
Content Type ◽  
Regional Brain ◽  
The Right

✓ A porcine model of regional intracranial pressure was used to compare regional brain tissue pressure (RBTP) changes during expansion of an extradural temporal mass lesion. Measurements of RBTP were obtained by placing fiberoptic intraparenchymal pressure monitors in the right and left frontal lobes (RF and LF), right and left temporal lobes (RT and LT), midbrain (MB), and cerebellum (CB). During expansion of the right temporal mass, significant RBTP gradients developed in a reproducible pattern: RT > LF = LT > RF > MB > CB. These gradients appeared early, widened as the volume of the mass increased, and persisted for the entire duration of the experiment. The study indicates that RBTP gradients develop in the presence of an extradural temporal mass lesion. The highest RBTP was recorded in the ipsilateral temporal lobe, whereas the next highest was recorded in the contralateral frontal lobe. The RBTP that was measured in either frontal lobe underestimated the temporal RBTP. These results indicated that if a frontal intraparenchymal pressure monitor is used in a patient with temporal lobe pathology, the monitor should be placed on the contralateral side and a lower threshold for therapy of increased intracranial pressure should be adopted. Furthermore, this study provides further evidence that reliance on a single frontal intraparenchymal pressure monitor may not detect all areas of elevated RBTP.

Brain tissue pressure gradients created by expanding frontal epidural mass lesion

1996 ◽  
Vol 84 (4) ◽  
pp. 642-647 ◽  
Author(s):  
Christopher E. Wolfla ◽  
Thomas G. Luerssen ◽  
Robin M. Bowman ◽  
Timothy K. Putty
Keyword(s):  
Balloon Catheter ◽  
Frontal Lobes ◽  
Mass Lesion ◽  
Maximum Pressure ◽  
Pressure Gradients ◽  
Tissue Pressure ◽  
Content Type ◽  
Temporal Lobes ◽  
Brain Parenchymal ◽  
The Right

✓ A porcine model was used to study the regional intracranial pressure (ICP) differences caused by a frontal mass lesion. Intraparenchymal ICP monitors were placed in the right and left frontal lobes, right and left temporal lobes, midbrain, and cerebellum. A frontal epidural mass lesion was created by placing a balloon catheter through a burr hole into the right frontal epidural space. A computer was used to acquire data from all monitors at 50-msec intervals. The balloon was expanded by 1 cc over a period of 1 second every 5 minutes and maximum pressure immediately before and during expansion was determined for each balloon volume at each site. Prior to expansion of the mass, the morphology of the cerebellum pressure tracing was different from that seen in all supratentorial regions. Also, pressures in the midbrain, at baseline, were slightly but significantly lower than pressures in the frontal and temporal regions. During expansion of the mass, a pressure differential that increased as the size of the mass increased developed between intracranial regions. Furthermore, the regional pressures were found to vary in a consistent fashion expressed by the formula RF = LF > RT = LT > MB > CB, in which RF and LF are the right and left frontal lobes, RT and LT are the right and left temporal lobes, MR is the midbrain, and CB is the cerebellum. The study shows that an expanding epidural mass reproducibly results in a gradient of brain parenchymal pressure. This gradient results in parenchymal pressures that are significantly different in each region of the brain depending on the proximity of that region to the epidural mass. The results of this study have implications for clinical ICP monitoring and therapy.

Malignant astrocytoma following radiotherapy of a craniopharyngioma

1978 ◽  
Vol 48 (4) ◽  
pp. 622-627 ◽  
Author(s):  
Richard L. Sogg ◽  
Sarah S. Donaldson ◽  
Craig H. Yorke
Keyword(s):  
Experimental Evidence ◽  
Temporal Lobe ◽  
Malignant Astrocytoma ◽  
Content Type ◽  
Suprasellar Region ◽  
The Right ◽  
Fine Print

✓ A 9-year-old schoolgirl received 6007 rads to the suprasellar region for craniopharyngioma. Five years later, a malignant astrocytoma developed in the right temporal lobe. We cite clinical and experimental evidence to support our suspicion that the glioma may have been induced by radiation.

Microvascular bypass surgery

1976 ◽  
Vol 44 (6) ◽  
pp. 712-714 ◽  
Author(s):  
Norman Chater ◽  
Robert Spetzler ◽  
Kent Tonnemacher ◽  
Charles B. Wilson
Keyword(s):  
Frontal Lobe ◽  
Temporal Lobe ◽  
Bypass Surgery ◽  
Angular Gyrus ◽  
Anatomical Studies ◽  
Content Type ◽  
Cortical Areas ◽  
Cortical Vessel ◽  
Suitable Location ◽  
Fine Print

✓ Microvascular anatomical studies were performed to ascertain the most suitable cortical vessel for extracranial-intracranial arterial bypass (EIAB). The three most commonly used cortical areas (the tip of the frontal lobe, the tip of the temporal lobe, and the area at the angular gyrus) were examined in detail. Because of their accessibility and size, the cortical arteries in the area of the angular gyrus offer the most suitable location for creating an EIAB.

Brain blood volume and blood flow in patients with plateau waves

1985 ◽  
Vol 63 (4) ◽  
pp. 556-561 ◽  
Author(s):  
Minoru Hayashi ◽  
Hidenori Kobayashi ◽  
Yuji Handa ◽  
Hirokazu Kawano ◽  
Masanori Kabuto
Keyword(s):  
Blood Flow ◽  
Caudate Nucleus ◽  
Frontal Lobe ◽  
Blood Volume ◽  
Temporal Lobe ◽  
Clinical Symptoms ◽  
Systemic Blood Pressure ◽  
Content Type ◽  
Rapid Sequence ◽  
Plateau Waves

✓ Plateau waves, characterized by acute transient rises of the intracranial pressure (ICP), are accompanied by a marked decrease of the cerebral perfusion pressure. Patients with plateau waves, however, often show no clinical symptoms of ischemia of the brain stem, such as vasopressor response or impairment of consciousness during the waves. The authors studied brain blood volume and blood flow with dynamic computerized tomography using rapid-sequence scanning in patients with plateau waves identified during continuous ICP recording. Following an intravenous bolus injection of contrast medium, density-versus-time curves were obtained for the regions of interest; that is, the frontal lobe, the temporal lobe, the caudate nucleus, the putamen, and the pons. The dynamic studies were undertaken when the ICP was high during a plateau-wave phase and when it was low during an interval phase between two plateau waves. The results indicate that, in the cerebral hemisphere (frontal lobe, temporal lobe, caudate nucleus, and putamen), plateau waves were accompanied by an increase in blood volume and, at the same time, a decrease in blood flow. In the pons, however, both the blood volume and blood flow showed little change during plateau waves as compared with the intervals between two plateau waves. These observations may explain why there is no rise in the systemic blood pressure and why patients are often alert during plateau waves.

Method for measuring brain tissue pressure

1975 ◽  
Vol 43 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Robert M. Clark ◽  
Norman F. Capra ◽  
James H. Halsey
Keyword(s):  
Blood Pressure ◽  
Brain Tissue ◽  
Systemic Blood Pressure ◽  
Systemic Blood ◽  
Tissue Pressure ◽  
Content Type ◽  
Pressure Changes ◽  
Local Brain

✓ The authors report a method for measuring total local brain tissue pressure (BTP) using a miniature catheter transducer stereotaxically introduced into the white matter of the cat's cerebrum. Quantitative rapid phasic pressure changes were satisfactorily demonstrated. Due to some drift of baseline of the transducers and inability to perform in vivo calibration, reliable long-term quantitative pressure measurements sometimes could not be studied. The BTP from each cerebral hemisphere and the cisternal pressure (CP) were monitored during alterations of pCO2 and systemic blood pressure, and distilled H2O injection prior to and after right middle cerebral artery (MCA) ligation. The catheter transducers functioned well on chronic implantation for up to 6 weeks. Compared to the chronically implanted catheters, acutely implanted catheters responded identically except for drift. The response of intracranial pressure and CP to MCA occlusion, alterations in pCO2, and systemic blood pressure were similar. No BTP gradients appeared in response to MCA ligation, hypercapnia, hypertension, or progressive swelling of the resulting infarction.

The effect of nimodipine on intracranial pressure

1987 ◽  
Vol 67 (3) ◽  
pp. 387-393 ◽  
Author(s):  
Mark N. Hadley ◽  
Robert F. Spetzler ◽  
Mary S. Fifield ◽  
William D. Bichard ◽  
John A. Hodak
Keyword(s):  
Blood Pressure ◽  
Intracranial Pressure ◽  
Systemic Blood Pressure ◽  
Artery Occlusion ◽  
Content Type ◽  
Arterial Blood ◽  
Increased Risk ◽  
Before And After ◽  
The Right ◽  
Cerebral Artery Occlusion

✓ Nimodipine was administered by intravenous infusion to six male baboons before, during, and after 6 hours of middle cerebral artery occlusion. Intracranial pressure (ICP) and systemic blood pressure were monitored continuously. An epidural balloon was inflated at regular intervals at three levels of arterial CO2 tension (25, 35, and 50 mm Hg) before and after the administration of nimodipine, and volume-pressure curves were generated. In every case, curves generated after intravenous nimodipine infusion were lower and shifted more to the right than the same set of curves generated before nimodipine administration, regardless of the baseline ICP. The reduction in ICP following nimodipine infusion was not due to a reduction in mean arterial blood pressure and was statistically significant at all three levels of pCO2 (p < 0.01). These results suggest that, in the presence of elevated ICP due to cerebral infarction, there is no increased risk of exacerbating intracranial hypertension with the addition of nimodipine.

Post-Stimulation Effect of Electroacupuncture at Yintang (EX-HN3) and GV20 on cerebral functional regions in healthy volunteers: A resting functional MRI study

2012 ◽  
Vol 30 (4) ◽  
pp. 307-315 ◽  
Author(s):  
Yu Zheng ◽  
Shanshan Qu ◽  
Na Wang ◽  
Limin Liu ◽  
Guanzhong Zhang ◽  
...  
Keyword(s):  
Frontal Lobe ◽  
Temporal Lobe ◽  
Parietal Lobe ◽  
Occipital Lobe ◽  
Cingulate Gyrus ◽  
Left Frontal Lobe ◽  
Posterior Cingulate Gyrus ◽  
Functional Regions ◽  
Limbic Lobe ◽  
The Right

Objective The aim of the present work was to observe the activation/deactivation of cerebral functional regions after electroacupuncture (EA) at Yintang (EX-HN3) and GV20 by functional MRI (fMRI). Design A total of 12 healthy volunteers were stimulated by EA at Yintang and GV20 for 30 min. Resting-state fMRI scans were performed before EA, and at 5 and 15 min after needle removal. Statistical parametric mapping was used to preprocess initial data, and regional homogeneity (ReHo) and amplitude of low-frequency fluctuation (ALFF) were analysed. Results ReHo at 5 min post stimulation showed increases in the left temporal lobe and cerebellum and decreases in the left parietal lobe, occipital lobe and right precuneus. At 15 min post stimulation, ReHo showed increases in the left fusiform gyrus; lingual gyrus; middle temporal gyrus; postcentral gyrus; limbic lobe; cingulate gyrus; paracentral lobule; cerebellum, posterior lobe, declive; right cuneus and cerebellum, anterior lobe, culmen. It also showed decreases in the left frontal lobe, parietal lobe, right temporal lobe, frontal lobe, parietal lobe and right cingulate gyrus. ALFF at 5 min post stimulation showed increases in the right temporal lobe, but decreases in the right limbic lobe and posterior cingulate gyrus. At 15 min post stimulation ALFF showed increases in the left frontal lobe, parietal lobe, occipital lobe, right temporal lobe, parietal lobe, occipital lobe and cerebellum, but decreases in the left frontal lobe, anterior cingulate gyrus, right frontal lobe and posterior cingulate gyrus. Conclusions After EA stimulation at Yintang and GV20, which are associated with psychiatric disorder treatments, changes were localised in the frontal lobe, cingulate gyrus and cerebellum. Changes were higher in number and intensity at 15 min than at 5 min after needle removal, demonstrating lasting and strong after-effects of EA on cerebral functional regions.

Differential intracranial pressure in patients with unilateral mass lesions

1982 ◽  
Vol 56 (5) ◽  
pp. 660-665 ◽  
Author(s):  
David D. Weaver ◽  
H. Richard Winn ◽  
John A. Jane
Keyword(s):  
Intracranial Pressure ◽  
Vascular Reactivity ◽  
Contralateral Side ◽  
Flow Dynamics ◽  
Increased Intracranial Pressure ◽  
Tissue Pressure ◽  
Content Type ◽  
Cerebrospinal Fluid Flow ◽  
Mass Lesions ◽  
Relationship Of

✓ Four patients with unilateral mass lesions are presented in whom bilateral supratentorial subarachnoid pressures were continuously recorded. A significant pressure differential between the ipsi- and contralateral side was documented in each case. The possible relationship of this phenomenon to various factors involved in producing increased intracranial pressure, including cerebrospinal fluid flow dynamics, vascular reactivity, elasticity, and brain tissue pressure, are discussed. This study suggests that supratentorial subarachnoid pressure should be measured ipsilateral to the site of a focal mass lesion.

Lymphomatoid granulomatosis apparently confined to one temporal lobe

1987 ◽  
Vol 67 (4) ◽  
pp. 612-615 ◽  
Author(s):  
Richard S. C. Kerr ◽  
J. T. Hughes ◽  
Trudi Blamires ◽  
Peter J. Teddy
Keyword(s):  
Macular Edema ◽  
Temporal Lobe ◽  
Cystoid Macular Edema ◽  
Lymphomatoid Granulomatosis ◽  
Diagnosis And Treatment ◽  
Pathological Findings ◽  
Content Type ◽  
The Right ◽  
Uncertain Etiology ◽  
Fine Print

✓ Lymphomatoid granulomatosis is of uncertain etiology and poses problems with diagnosis and treatment. A case with involvement of the right temporal lobe, but associated with cystoid macular edema of the retina, is described. The unusual mode of presentation, the radiographic, operative, and pathological findings, the response to surgery and radiotherapy, and the possible etiology are discussed.

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