1/5. Characteristic oscillations of intracranial pressure after delayed lowering of blood pressure in patient with shearing injury.A comatose patient with severe shearing injury showed hyperthermia, leucocytosis and decerebration. Rapid disappearance of brain swelling as well as a transient fall of blood pressure were peculiar in his clinical course. Large pressure waves appeared more frequently after such attacks. The authors concluded that cerebral vasomotor instability was caused by a primary lesion throughout an area from the anterior hypothalamus to the upper brain stem. Pre-existing hypoxia in such primary lesions was augmented by hypotensive episodes. Frequent appearance of large pressure waves was thought to represent progressive vascular engorgement followed by an uncontrollable increase of the ICP.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
2/5. Increased intraventricular pressure without ventriculomegaly in children with shunts: "normal volume" hydrocephalus.Five patients with shunt-dependent hydrocephalus were observed to have apparently normal ventricular size despite marked increases in ventricular pressure after shunt malfunction. Elastance (dP/dV) was determined in four of these patients by removing increments of cerebrospinal fluid and measuring the resulting pressure. These patients without ventricular enlargement and with markedly increased ventricular pressure had high elastance. This group of patients with "normal volume" hydrocephalus had distal shunt occlusions, in contrast to previously reported patients with cephalic shunt obstructions after ventricular decompression. Initial shunting in early infancy, prolonged shunt dependency, and lack of recent shunt revision were common factors in these patients. Markedly elevated pressure with normal volume is a threatening clinical entity, requiring prompt surgical intervention- - - - - - - - - - ranking = 0.72727272727273keywords = pressure (Clic here for more details about this article) |
3/5. eclampsia--monitoring of intraventricular CSF pressure.Continuous monitoring of the intraventricular CSF pressure was performed for 48 h in a woman of 23 years who had postpartum eclampsia with unconsciousness for 5 days and decerebrate spasms suggesting compression of the upper brainstem. The intraventricular pressure was normal with minor variations of 10--20 mm Hg.- - - - - - - - - - ranking = 0.54545454545455keywords = pressure (Clic here for more details about this article) |
4/5. The effect of decerebrate rigidity on intracranial pressure in man and animals.patients with decerebrate rigidity frequently show intracranial hypertension. The factors responsible for this effect and their inter-relationships were explored in cats and in patients with head injuries. animals: The factors examined, separately and in combination, were elevation of central venous, intrathoracic, intra-abdominal and systemic arterial pressures. The baselines thus established were used for the investigation of the effects of these factors on the intracranial pressure (ICP) in cats which had been rendered decerebrate by focal stereotactic mesencephalic lesions. Little or no change occurred in the ICP when: Rigidity was mainly unilateral. Bilateral limb rigidity was extreme. Persistent elevation of ICP occurred when: Truncal rigidity resulted in the simultaneous elevation of the intrathoracic and intra-abdominal pressures. Elevation of the systemic arterial pressure occurred in the presence of defective cerebrovascular homeostasis. Human: The dynamics and management of the complex clinical problem posed by decerebrate rigidity were investigated in patients with head injuries who exhibited well-developed bilateral rigidity under conditions of altered cerebral elastance. Rigidity was quantified by measuring the resonant frequency of the wrist induced by a printed-circuit motor. The brain elastance, ICP, intrathoracic and blood pressures were measured throughout the study. The effect of pharmacological muscle paralysis on the ICP and rigidity was examined. It appeared that well-developed decerebrate rigidity increased the ICP. The relationship was direct; the greater the rigidity or cerebral elastance, the greater the rise in ICP and vice versa. The two factors mainly responsible were muscle hypertonicity and cerebral elastance. The rises in ICP were caused by the rigidity and although it may not always be possible to reduce the abnormally increased elastance, the rigidity can certainly be abolished. As long as the cerebral vascular homeostatic mechanisms were intact, spontaneous waning of the rigidity or its abolition by muscle relaxants returned the ICP to its previous resting level. pancuronium produced much deeper and more lasting relaxation than either diazepam or chlorpromazine. During the period of mechanical ventilation, alterations in ICP were of prognostic value as regards the outcome of the injuries.- - - - - - - - - - ranking = 0.81818181818182keywords = pressure (Clic here for more details about this article) |
5/5. Bilateral chronic subdural hematomas associated with intracranial hypotension--case report.A 56-year-old female presented with chronic subdural hematoma due to spontaneous (primary) intracranial hypotension (SIH). She was admitted in a deep coma. Computed tomography showed bilateral chronic subdural hematomas with tight basal cisterns. Percutaneous aspiration of the chronic subdural hematoma with the twist drill revealed negative pressure. The neurological symptoms rapidly improved postoperatively, but the chronic subdural hematoma recurred three times, requiring further aspiration procedures. patients with SIH may develop subdural hematoma requiring surgical treatment.- - - - - - - - - - ranking = 0.090909090909091keywords = pressure (Clic here for more details about this article) |