BACKGROUND Elevated intracranial pressure (ICP) is a common cause of death in acute liver failure (ALF) and is determinant for decision-making regarding the timing of liver transplantation. The recommended type ICP monitoring device is controversial in ALF patients. Epidural devices had less risk of hemorrhagic complications, but they are less reliable than intraparenchymal ones. METHOD Twent...

BACKGROUND Intracranial pressure (ICP) monitoring is considered the standard of care for severe traumatic brain injury (TBI) and is used frequently, but the efficacy of treatment based on monitoring in improving the outcome has not been rigorously assessed. METHODS OBJECTIVE The objective was to compare efficacy of guideline-based management in which a protocol for monitoring intraparenchy...

Increased intracranial pressure (ICP) has an adverse effect on the clinical course of patients with severe head injuries. Direct intracranial measurement is the only method of knowing the precise ICP. At the Maryland Institute for Emergency Medical Services Systems, elevations in ICP are treated according to an aggressive protocol. Our experience with this protocol has led to the following conc...

INTRODUCTION Intracranial pressure (ICP) measurement is used to tailor interventions and to assist in formulating the prognosis for traumatic brain injury patients. Accurate data are therefore essential. The aim of this study was to verify the accuracy of ICP monitoring systems on the basis of a literature review. METHODS A PubMed search was conducted from 1982 to 2014, plus additional refere...

BACKGROUND Transcranial Doppler (TCD) has been used to estimate ICP noninvasively (nICP); however, its accuracy varies depending on different types of intracranial hypertension. Given the high specificity of TCD to detect cerebrovascular events, this study aimed to compare four TCD-based nICP methods during plateau waves of ICP. METHODS A total of 36 plateau waves were identified in 27 patien...

In twelve anaesthetised, ventilated dogs the effects of hypercapnia and pharmacologically induced arterial hypotension and hypertension on the interrelation between volume-pressure response (VPR) and cerebro-spinal fluid (CSF) pulse pressure were studied during continuous inflation of a supratentorial extradural balloon. Hypercapnia did not significantly affect the intracranial volume-pressure ...

SUDEP is the sudden unexpected death of a person with epilepsy, when no structural or toxicological cause of death can be found. The majority of witnessed cases are reported to be preceded by a convulsive seizure and postictal hypoventilation. Here, we report an 8-year-old girl with drug-resistant focal seizures secondary to a focal cortical dysplasia type IIb. While undergoing invasive intracr...

traumatic basal ganglia hematoma is a rare condition defined as presence of hemorrhagic lesions in basal ganglia or adjacent structures suchas internal capsule, putamen and thalamus. bilateral basal ganglia hematoma are among the devastating and rare condition. we herein report a 28-year old man, a victim of car-car accident who was brought to our surgical emergency room by immediate loss of co...

PURPOSE Intraarterial papaverine infusions are performed to reverse cerebral arterial vasospasm resulting from subarachnoid hemorrhage, but such infusions may lead to increases in intracranial pressure (ICP). This study was undertaken to determine when ICP monitoring is indicated during papaverine treatment. METHODS Seventy-eight vessels were treated in 51 sessions in 28 patients with symptom...

I n patients with pseudotumor cerebri, it is critical to intervene surgically if visual loss continues despite medical therapy (1). This sounds like a simple rule to follow, but in reality, the decision to recommend surgery can be fraught with uncertainty. The essential problem is that if one gives medical therapy a chance to work, it may not be possible to snatch the bacon from the fire. By th...