The predictive values of certain features of computerized tomographic (CT) scans in estimating intracranial pressure (ICP) were investigated in 40 patients following closed head injuries. The various features of CT scans selected for study included ventricular compression, the size of the parenchymal mass lesion, midline shift, and an intraventricular clot. All patients with intraventricular clot exhibited severe elevation of pressure. Ventricular compression correlated well with the level of intracranial pressure. Size of the mass was found to be suggestive of pressure elevation but did not reach statistical significance. Midline shift showed no correlation with the intracranial pressure.
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http://dx.doi.org/10.1016/0090-3019(82)90395-0 | DOI Listing |
Intensive Care Med
January 2025
Global Health Research Group in Acquired Brain and Spine Injuries, Cambridge, UK.
Background: Invasive systems are commonly used for monitoring intracranial pressure (ICP) in traumatic brain injury (TBI) and are considered the gold standard. The availability of invasive ICP monitoring is heterogeneous, and in low- and middle-income settings, these systems are not routinely employed due to high cost or limited accessibility. The aim of this consensus was to develop recommendations to guide monitoring and ICP-driven therapies in TBI using non-invasive ICP (nICP) systems.
View Article and Find Full Text PDFJ Neurotrauma
January 2025
Department of Anaesthesia and Intensive Care, Centre Hospitalier Universitaire Grenoble, and Inserm, U1216, Grenoble Institut Neurosciences, University Grenoble Alpes, Grenoble, France.
The effect of sex in outcomes after severe traumatic brain injury (TBI) remains uncertain. We explored whether outcomes differed between women and men after standardized care management during the first 5 days in the intensive care unit (ICU). This study was an observational analysis of the OXY-TC multicenter randomized clinical trial between June 15, 2016 and April 17, 2021.
View Article and Find Full Text PDFCureus
December 2024
Neurosurgery, Queens Hospital Center, Romford, GBR.
We report the management of a convexity dural arteriovenous fistula (dAVF) in an uncommon anterior superior sagittal sinus (SSS) location. This was a high-risk Cognard IIa+b dAVF, which is notoriously complex to treat. Endoscopic management alone for complex SSS dAVFs is challenging due to the often bilateral arterial supply to the fistula, as demonstrated in this case.
View Article and Find Full Text PDFJ Clin Neurosci
January 2025
Department of Ultrasonic Medicine, Fudan University Affiliated Huashan Hospital, No 12, Middle Wulumuqi Road, Shanghai 200040, China. Electronic address:
Objective: This prospective observational study aimed to assess the effectiveness of B-mode ultrasound, color-coded Doppler, and shear-wave elastography in predicting intracranial pressure (ICP) and their capability to evaluate the efficacy of ICP lowering therapy.
Materials And Methods: Forty-eight neuro-critical care patients were enrolled and categorized into 2 groups based on ICP measurements obtained through external ventricular drainage: the intracranial hypertension (IH) and normal ICP groups. The optic nerve (ON) sheath diameter (ONSD), end diastolic velocity, peak systolic velocity, resistance index of the central retinal artery (CRA), and Young's modulus (YM) of the ON were recorded after external ventricular drainage placement and following ICP lowering treatment in the IH group.
J Surg Res
January 2025
Division of Trauma and Critical Care, Department of Surgery, Reading Hospital, West Reading, Pennsylvania. Electronic address:
Introduction: It is unclear if intracranial pressure monitoring (ICPM) after open cranial procedures (craniotomy or craniectomy) (OC) for traumatic brain injury is associated with mortality. We hypothesized that ICPM placed early after OC was associated with lower mortality compared to no ICPM or delayed ICPM placement.
Methods: Using 2020-2021 data from the American College of Surgeons Trauma Quality Improvement Program, patients ≥16 y from level 1 and 2 trauma centers who underwent OC were divided into two groups: ICPM placed within 72 h of OC (early) and no ICPM or ICPM placed after 72 h (none/delayed).
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