Acta neurochirurgica. Supplement
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Acta Neurochir. Suppl. · Jan 2008
Accuracy of non-invasive ICP assessment can be increased by an initial individual calibration.
In a formerly introduced mathematical model, intracranial pressure (ICP) could be non-invasively assessed using cerebral blood flow velocity (FV) and arterial blood pressure (ABP). The current study attempts to check whether the accuracy of the non-invasive ICP assessment (nICP) improves after an initial individual calibration by implanted ICP probes. ⋯ Initial individual calibration of nICP assessment method significantly improves the accuracy of nICP estimation on subsequent days. This hybrid method of ICP assessment may be used in intensive care units in patients with initially implanted ICP probes. After removal of the probes, ICP monitoring can be continued using the calibrated nICP assessment procedure.
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Acta Neurochir. Suppl. · Jan 2008
Microglial activation and brain injury after intracerebral hemorrhage.
Microglial activation and thrombin formation contribute to brain injury after intracerebral hemorrhage (ICH). Tumor necrosis factor-alpha (TNF-alpha) and interleukin-1 beta (IL-1beta) are 2 major proinflammatory cytokines. In this study, we investigated whether thrombin stimulates TNF-alpha and IL-1beta secretion in vitro, and whether microglial inhibition reduces ICH-induced brain injury in vivo. ⋯ Tuftsin reduced thrombin-induced upregulation of TNF-alpha and IL-1beta. In vivo, microglia were activated after ICH, and intracerebral injection of tuftsin reduced brain edema in the ipsilateral basal ganglia (81.1 +/- 0.7% vs. 82.7 +/- 1.3% in vehicle-treated group; p < 0.05) after ICH. These results suggest a critical role of microglia activation in ICH-related brain injury.
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Acta Neurochir. Suppl. · Jan 2008
ICM+, a flexible platform for investigations of cerebrospinal dynamics in clinical practice.
ICM+ software encapsulates 20 years of our experience in brain monitoring gained in multiple neurosurgical and intensive care centres. It collects data from a variety of bedside monitors and produces on-line time trends of parameters defined using configurable signal processing formulas. The resulting data can be displayed in a variety of ways including time trends, histograms, cross histograms, correlations, etc. For technically minded researchers there is a plug-in mechanism facilitating registration of third party libraries of functions and analysis tools. ⋯ ICM+ software proved to be useful both academically and clinically. The complexity of data analysis is hidden inside loadable profiles thus allowing clinically minded investigators to take full advantage of signal processing engine in their research into cerebral blood and fluid dynamics.
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Hypertonic saline (HTS) has been proposed as a treatment after aneurysmal subarachnoid hemorrhage (SAH) to minimize ischemic brain injury due to its osmotic and rheologic properties. Although the benefits of 7.2% HTS use in brain injury have been studied, there is a paucity of data on the use of 3%HTS. ⋯ Given the potential adverse effects of HTS therapies, including hyperchloremic acidosis, and the lack of benefit found in our study, more investigation is required to evaluate the clinical use of 3%HTS in the setting of SAH.
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Acta Neurochir. Suppl. · Jan 2008
The relationship between intracranial pressure and brain oxygenation following traumatic brain injury in sheep.
While it is understood that raised intracranial pressure (ICP) after traumatic brain injury (TBI) may negatively impact on brain tissue oxygenation (PbtO2), few studies have characterized the inter-relationship between these two variables, particularly in a large animal model that replicates the human gyrencephalic brain. The current study uses an ovine model to examine the dynamics of ICP and PbtO2 after TBI. ⋯ Our results suggest that TBI results in early changes in ICP that are associated with profound declines in PbtO2, and may indicate the need for earlier management of ICP after TBI.