Use of vasopressors to raise cerebral perfusion pressure in head injured patients.

Cerebral ischemia due to low cerebral perfusion pressure (CPP) is the most important secondary effect of severe head injury. There is consensus regarding the maintenance of this pressure at levels above 70 mm Hg. One way to elevate CPP is by increasing mean arterial pressure (MAP).

Osmotherapy for increased intracranial pressure: comparison between mannitol and glycerol.

Osmotic agents are still the most common treatment for controlling intracranial hypertension (ICH). Mannitol, glycerol, sorbitol, and hypertonic serum saline are the agents currently available. This work was designed to compare mannitol and glycerol in a similar population of brain injured patients, randomly divided into two groups of eight.

Use of indomethacin in brain-injured patients with cerebral perfusion pressure impairment: preliminary report.

The effect of indomethacin, a cyclooxygenase inhibitor, was studied in the treatment of 10 patients with head injury and one patient with spontaneous subarachnoid hemorrhage, each of whom presented with high intracranial pressure (ICP) (34.4 +/- 13.1 mm Hg) and cerebral perfusion pressure (CPP) impairment (67.

[Intracranial hemorrhage in hemophiliacs. Study of 10 episodes].

The intracranial haemorrhages presented within a group of 64 haemophiliacs along 25 years were revised. During this period, 10 such episodes were seen in 8 patients with haemophilia A; six of them appeared in children under 10 years of age. In five instances there were traumatic antecedents, whereas in the remaining five the haemorrhage was spontaneous, no vascular abnormalities being demonstrated in these last.

Wartime neurosurgical experience in Lebanon, 1982-85. II: Closed craniocerebral injuries.

This report presents 64 patients who sustained military-related closed craniocerebral injuries during the Lebanon conflict of 1982-85, all of whom underwent CT scanning at the initial assessment. Of these, 59% required surgery for removal of hematomas, depressed fractures and for monitoring intracranial pressure, in addition to intensive care management of elevated intracranial pressure and associated insults. CT scan revealed brain concussion only in 23%, depressed fracture in 9%, brain contusion alone in 17%, extracerebral hematomas in 17%, intracerebral hematomas in 11%, and diffuse axonal injury in 22%.