Acta neurochirurgica. Supplement
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Acta Neurochir. Suppl. · Jan 2012
Non-invasively estimated ICP pulse amplitude strongly correlates with outcome after TBI.
An existing monitoring database of brain signal recordings in patients with head injury has been re-evaluated with regard to the accuracy of estimation of non-invasive ICP (nICP) and its components, with a particular interest in the implications for outcome after head injury. ⋯ When compared between patients who died and who survived mean nAmp showed the greatest difference, suggesting its potential to predict mortality after TBI.
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Acta Neurochir. Suppl. · Jan 2012
Pulse amplitude and Lempel-Ziv complexity of the cerebrospinal fluid pressure signal.
The complexity of the intracranial pressure (ICP) signal decreases with intracranial hypertension in children with acute brain injury as well as during infusion studies in adults with hydrocephalus. In this study we have analysed the pressure signal obtained in the lumbar subarachnoid space during infusion testing. The pulse amplitude rises when the ICP is increased by additional external volume. Our objective was to determine the relative influence of the pressure range and pulse amplitude on the loss of complexity observed during infusion-related intracranial hypertension. ⋯ The pulse amplitude of the CSFP signal seems to be a major determinant of the waveform complexity.
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Acta Neurochir. Suppl. · Jan 2012
Randomized Controlled TrialA microdialysis study of oral vigabatrin administration in head injury patients: preliminary evaluation of multimodality monitoring.
We assessed the feasibility of administering a neuroprotective drug, vigabatrin (VGB; gamma-vinyl-gamma-aminobutyric acid) with multimodality monitoring, including cerebral microdialysis, in severe head injury patients, to measure surrogate endpoints and blood-brain barrier (BBB) penetration. ⋯ Multimodality monitoring, including cerebral microdialysis, is feasible for studying surrogate endpoints following drug administration. VGB crosses the BBB, leading to modest increases in extracellular GABA. Further analyses are ongoing. Microdialysis may assist the development of neuroprotective agents by determining penetration into extracellular fluid of the brain.
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Acta Neurochir. Suppl. · Jan 2012
Correlation of clinical outcome and angiographic vasospasm with the dynamic autoregulatory response after aneurysmal subarachnoid hemorrhage.
A certain correlation between unfavorable clinical outcome, incidence of vasospasm, and impaired pressure autoregulation in patients following aneurysmal subarachnoid hemorrhage (aSAH) has been suggested. However, determination of vasospasm is inaccurate and the measurement technique of cerebral vasoreactivity seems not to have been sufficiently validated. Therefore, a correlation of clinical outcome and the extent of angiographic VS was performed using an established autoregulation test. ⋯ Incidence of angiographic vasospasm and impaired clinical outcome seems to be related to impaired pressure autoregulation following aSAH.
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Acta Neurochir. Suppl. · Jan 2012
Realization of a comprehensive non-invasive detection of intracranial pressure analyzer based upon FVEP and TCD.
Up to now, several methods, such as flash visual evoked potential (FVEP) and transcranial Doppler (TCD), have been studied with regard to assessing intracranial pressure (ICP) non-invasively. However, there are still no instruments that are readily available for non-invasive measurement of ICP in clinical practice. Based on the advantages of FVEP and TCD for ICP assessment, the two methods are synthesized to develop a specific instrument to non-invasively measure ICP more reliably and applicably, as the integration of FVEP and TCD overcomes the shortcomings of a single method of ICP measurement.