Intracranial Pressure IV PDF
Preview Intracranial Pressure IV
Intracranial PressureN Edited by K. Shulman A. Marmarou J. D. Miller D. P. Becker G. M. Hochwald M. Brock With 235 Figures and 82 Tables Springer-Verlag Berlin Heidelberg New York 1980 Kenneth Shulman, M. D. Anthony Marmarou, Ph.D. Leo M. Davidoff Department of Neurological Surgery, Albert Einstein College of Medicine, Yeshiva University, 1300 Morris Park Avenue, Bronx, NY 10461 (USA) J. Douglas Miller, M. D., Ph.D., PReS Donald P. Becker, M. D. Virginia Commonwealth University, Medical College of Virginia, Division of Neurological Surgery, 1200 East Broad Street, Richmond, VA 23298 (USA) Gerald M. Hochwald, M. D. Department of Neurology, New York University Medical Center, 550 First Avenue, New York, NY 10016 (USA) Prof. Dr. Mario Brock Universitiitsklinikum Steglitz, Neurochirurgische Klinik und Poliklinik, Freie Universitiit Berlin, Hindenburgdamm 30, D-1OOO Berlin 45 (FRG) ISBN-13: 978-3-642-67545-4 e-ISBN-13: 978-3-642-67543-0 DOI:I0.I007/ 978-3-642-67543-0 Library of Congress Cataloging in Publication Data. International Symposium on Intracranial Pressure, 4th, Williamsburg, Va., 1979. Intracranial pressure IV. "Proceedings of the fourth International Symposium on Intracranial Pressure held in Williamsburg, Virginia, USA, June 10-14, 1979." Bibliography: p. Includes index.!. Brain--Diseases·-Congresses. 2. Intracranial pressure·-Congresses. I. Shulman, Kenneth, 1928-. II. Title. [DNLM: 1. Intracranial pressure--Congresses. W3 IN995] RC386.156 1979 616.8 79-29761 This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically those of translation, reprinting, re·use of illustrations, broadcasting, reproduction by photocopying machine or similar means, and storage in data banks. Under § 54 of the German Copyright Law, where copies are made for other than private use, a fee is payable to the publisher, the amount of the fee to be determined by agree ment with the publisher. © by Springer·Verlag Berlin Heidelberg 1980 Softcover reprint of the hardcover 1st edition 1980 The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protec tive laws and regulations and therefore free for general use. Offsetprinting: Beltz Offsetdruck, Hemsbach/Bergstr. 212713140-543210 Proceedings of the Fourth International Symposium on Intracranial Pressure Held at Williamsburg, Virginia, USA, June 10-14, 1979 Organizing Committee Advisory Committee 1. D. Miller, Richmond, T. W. Langfitt, Philadelphia, Secretary Chairman D. P. Becker, Richmond J. W. F. Beks, Groningen G. M. Hochwald, New York M. Brock, Berlin A. Marmarou, New York P. Janny, Clermont-Ferrand K Shulman, New York B. Jennett, Glasgow N. Lundberg, Lund v Preface This book contains the papers delivered at the Fourth International Symposium on Intracranial Pressure, held at Williamsburg, Virginia, USA, June 10-14, 1979. Divided into 12 sessions, they reflect the most recent developments in areas such as head injuries, pressure volume studies, cerebrovascular complications, intracranial hemor rhage, brain edema, systemic factors and infectious processes, data recording and analysis, CSF formation and absorption, hydroce phalus, clinical aspects of ICP monitoring, anesthesia and intra cranial pressure, treatment with barbiturates and steroids, and os motherapy. The book concludes with a summary of the present state-of-the-art in the field as a whole by Dr. Langfitt. There were two innovations at this Symposium. The first of these was poster sessions, the second, breakfast seminars. This volume contains all papers read plus all those presented as posters, and for this reason contains more pages than the three previous volumes. The organizers wish to thank the Advisory Committee for the work done in paper selection and focus of the Conference. Appreciation is also given to the Chairmen and Co-chairmen of the sessions for the preparation of summary statements. Manuscript preparation was performed by Ms. Lucille Browne, and gratitude is expressed to her. The next Symposium, the Fifth International Conference on ICP, will be held in Japan in 1982. We also wish to acknowledge the technical help of Springer-Verlag and their celerity in producing this volume. The Editors VII Contents Session I. Head Injury Chairman: D. P. BECKER; Co-chairman: I. PAPO Summary . . . . . . . . . . . .. 3 ICP and Outcome in Patients with Severe Head Injury L. H. PITTS, J. V. KAKTIS, R. JUSTER, and D. HEILBRON . . . . . . . . .. 5 Prognostic Significance of Intracranial Pressure and Neurological Condition in Acute Brain Lesions K. E. RICHARD and R. A. FROWEIN. . . . . . . . . . . . . . . . . 10 Role ofICP Monitoring in Patients Suffering from Severe Brain Injuries M. COLLICE, P. VERSARI, G. VECCHI, A. SCORNAJENGHI, and V. D'ANGELO. . . . 17 Brain Damage in Fatal Non-Missile Head Injury Without Neuropathological Evidence ofHighICP D. I. GRAHAM, J. H. ADAMS, and D. DOYLE . . . . . . . . . . . . . . 20 Relations of Cerebral Perfusion Pressure and Hematocrit with Hemispheric Cerebral Blood Flow During Post-Traumatic Coma F. ARTRU, B. PHILIPPoN, M. BERGER, and R. DELEUZE . . . . . . . . . . 24 ICP in Experimental Head Injury T. A. GENNARELLI, Z. CZERNICKI, H. SEGAWA, R. WISER, K. MARSH, U. WALD, H. ADAMS, and D. GRAHAM . . . . . . . . 28 Time Course in Intracerebral Traumatic Hematomas I. PAPO, G. CARUSELLI,andM. SCARPELLI. . . . 33 Operate or Observe? ICP and the Management of the 'Silent' Traumatic Intracranial Haematoma G. TEASDALE, S. GALBRAITH, and B. JENNETT . . . . . . . . . . . . . 36 Brain Interstitial Fluid Pressure Measurement in Head Injury Patients S. NAKATANI, K. KOSHlNO, H. MOGAMI, Y. SAWADA, and T. SUGIMOTO 39 Relevance of Cat-Scan for the Level ofICP in Patients with Severe Head Injury L. AUER, R. OBERBAUER, H. TRITTHART, W. D. SAGER, and G. CLARICI . 45 Can CT Scan Findings Predict Intracranial Pressure in Closed Head Injury Patients? F. L. HAAR, V. K. SADHU, R. S. PINTO, P. L. GILDENBERG, and J. M. SAMPSON. 48 Factors Influencing Survival and Quality of Survival in Patients Treated for Elevated Intracranial Pressure C. P. MCGRAW and G. HOWARD. . . . . . . . . . . . . . . . . . 54 The Prognostic Value of Intracranial Pressure (lCP) Measurement in Relation to the Different Factors that Can Affect ICP E. B. BONGARTZ, H. E. NAU, L. GERHARD, J. LIESGANG, and W. J. BOCK . . . . . 56 IX Does the Pressure-Volume Relationship Exist? A. L. BENABID, J. DE ROUGEMONT, J. P. CHIROSSEL, and M. BARGE 60 Experimental Brain Injury in the Dog: Pathophysiological Correlation R. J. CLUBB, R. MAxwELL, and S. CHOU . . . : . . . . . . 66 Correlations Between Intracranial Pressure, Neurologic Deficit and Computer Tomo graphic Findings in Patients with Acute Severe Head Injury. A Clinical Study P. FASOL, H. BINDER, T. REISNER, R. SCHEDL, L. SCHMID, and M. STRICKNER 70 Continuous Measurement ofIntracranial Pressure in 127 Severe Head Injuries D. P. BYRNES and T. B. DUCKER. . . . . . . . . . . . . . . 73 Session II. Pressure-Volume Studies Chairman: A. MARMAROU; Co-chairman: A. L. BENABID Summary ............... . 79 The Pressure-Volume Function of Brain Elasticity and its Relationship with Ventricular Size F. H. SKLAR, C. W. BEYER, JR., H. HAGLER, M. RAMANATHAN, and W. K. CLARK 81 A Method for Predicting PYI in Normal Patients K. SHAPIRO, A. MARMAROU, and K. SHULMAN . . . . . . . . . . . . . 85 Drastic Dehydration as a Treatment ofIntracranial Hypertension in Severe Head Injuries A. L. BENABID, A. BAUD, J. DE ROUGEMONT, F. F ACCIOLI, M. BARGE, and J. P. CHIROSSEL ................. 88 The CSF Pressure-Volume Relationship Before and After Cardiac Arrest H. G. SULLIVAN, J. D. MILLER, and R. L. GRIFFITH . . . . . . 91 CSF Pressure-Volume Relation and Pulse Related CSF Pressure Variations in Man H. FRIDEN and J. EKSTEDT. . . . . . . . . . . . . . . 93 Effects of Cerebral Edema Upon Viscoelastic Properties of Brain Tissue A. MARMAROU,H. TAKAGI,C. W. HARGENS,andK. SHULMAN 97 Parameters for Identifying Brain Response Properties in vivo E. K. WALSH and A. SCHETTINI . . . . . . . . . . 102 Dynamics of Transtentorial Herniation S. YONEDA, M. MATSUDA, H. HANDA, H. GOTOH, and E. TSUDA 106 Intrabrain Pressure, Cerebrospinal Fluid Pressure and the PV Function of Craniospinal System Elasticity in Patients After the Extraction of Tumors from the Basal Region and Posterior Fossa E. I. PALTSEV and E. B. SIROVSKY . . . . . . . . . . 111 Clinical Experiences with Intracranial Volume-Pressure Response I. NYARY, 1. VAJDA, and E. PASZTOR . . . . . . . . . 116 A Diagrammatic, Two-Dimensional Model for Interpretation of Craniospinal PN Inter actions H. G. SULLIVAN, J. D. MiLLER, and R. L. GRIFFITH 120 Etiology ofB-Waves S. C. S0RENSEN, F. GJERRIS, and S. E. B0RGESEN . 123 x Session III. Cerebrovascular Aspects Chairman: J. D. MILLER; Co-chairman: N. N. ZWETNOW Summary . . . . . . . . . . . . . . .. 129 Intracranial Pressure and Regional Cerebral Blood Flow Responses to Experimental Brain Retraction Pressure M. S. ALBIN, L. BUNEGIN, P. HELSEL, A. MARLIN, and M. BABINSKI . . . . . . 131 Electrophysiological Changes Associated with Local Brain Compression S. FUJIMOTO, H. KUYAMA, K. NISHIMOTO, T. AKIOKA, S. NAGAO, and A. NISHIMOTO 136 Influence of Mild Hypercapnia on Intracranial Pressure in Ischemic, N on-Infarcted Brain Tissues Y. NAKAGAWA, Y. L. YAMAMOTO, W. FEINDEL, E. MEYER, and M. TSURU . . . 139 Simultaneous Subacute Measurement ofICP and Brain 02 Availability R. B. MORAWETZ, H. L. MITCHEM, E. R. STRONG, J. G. GALBRAITH, and J. H. HALSEY 142 Intracranial Dynamics Associated with Experimentally Induced Pressure Waves H. KUCHIWAKI, M. FURUSE, T. NAKAYA, K. TOYAMA, A. IKEYAMA, M. HASUO, M. TERAOKA,andN.KAGEYAMA. . . . . . . . . . . . . . . . . . 147 Sympathetic Role of Posterior Hypothalamus in the Development of Acute Brain Swelling Y. NAKAGAWA, M. TSURU, K. OHTUSKA, and M. MOTOMIYA. . . . . . . . . 150 The CSF Pulse Pressure in Relation to Intracranial Elastance and Failure of Autoregu lation J. H. M. VAN EIJNDHOVEN, C. J. J. AVEZAAT, and D. J. WYPER . . . . . . . . 153 Effects of Hypercapnia and Systemic Arterial Hypo- and Hypertension on the Inter relation Between CSF Pulse Pressure and Volume-Pressure Response C. J. J. AVEZAAT, J. H. M. VAN EIJNDHOVEN, and D. J. WYPER . . . . . . 159 The Effect of Blood Pressure and PaC02 Upon Bulk Compliance (PVI) H. TAKAGI, G. WALSTRA, A. MARMAROU, and K. SHULMAN 163 Spectral Analysis ofIntracranial Pressure H. D. PORTNOY and M. CHOPP . . . . . . . . . . . . . . 167 The Analogy Between CSF Pulse Pressure and Volume-Pressure Response J. H. M. VAN EIJNDHOVEN and C. J. J. AVEZAAT . . . . . . . . 173 Brain Stem - Cerebellar and Hemispheric Blood Flow in Stupor and Impaired States of Responsiveness with and without Intracranial Hypertension M. YAMAMOTO, J. S. MEYER, F. SAKAI, and F. YAMAGUCHI . . . . . . . . . 177 Measurement of Regional Cerebral Blood Volume by Photoelectric Method H. KUYAMA, S. FUJIMOTO, M. TSUCHIMOTO, K. NISHIMOTO, T. AKIOKA, A. MATSU MOTO, and A. NISHIMOTO . . . . . . . . . . . . . . . . . . . . 180 ICP and EEG in Various Forms of Cerebral Seizures O. E. KNOBLICH, M. GAAB, and W. WEBER . . . . . . . . . . . . . . 183 Analysis of the Wave Pattern of CSF Pulse Wave A. GEGA,S. UTSUMI, Y.IIDA,N.IIDA,andS. TSUNCDA. . . . . . . . . . . 188 Study of the CSF Pulsation Transfer: Application to the Frequency Analysis D. GODIN, A. STEVENAERT, and R. LHOMMEL 191 Blood Pressure Factors Causing Raised ICP A. IKEYAMA, T. NAKAYA, M. TERAOKA, M. HASUO, S. MAEDA, H. KUCHIWAKI, M. FURUSE, and H. NAGAI. . . . . . . . . . . . . . . . . . . . 195 XI Session IV. Intracranial Hemorrhage Chairman: M. BROCK; Co-chairman: J. A. JANE Summary . . . . . . . . . . . . . . . . . . . . . . . . 201 ICP Time Course in Primary Intracerebral Hemorrhage I. PAPO, P. JANNY, G. CARUSELLI, G. COLNET, and A. LUONGO . . . . 203 The Effect of Experimentally Produced Intracranial Hematoma Upon ICP P. MOHR and R. LORENZ . . . . . . . . . . . . . . . . 207 Intraventricular Pressure, CSFLactate and VasospasminRupturedIntracranialAneurysm B. VOLBY and E. M. ENEVOLDSEN . . . . . . . . . . . . . .. 211 Intracranial Pressure Changes in Patients with Diffuse Cerebral Vasospasm M. HAYASHI, H. FUJII, T. KITANO, H. KOBAYASHI, S. MUNEMOTO, Y. HANDA, and S. YAMAMOTO . . . . . . . . . . . . . . . . . . . . . 215 Continuous Monitoring of CSF Pressure in Acute Subarachnoid Hemorrhage A. HARTMANN. . . . . . . . . . . . . . . . . . . . 220 Polygraphic Study of CSF Pressure Waves During Coma F. CALBUCCI, W. DALLOLIO, E. BENERICETTI, A. DORIZZI, and C. MUNARI . . . . 229 Hydrocephalus Following Early Operation of Ruptured Cerebral Aneurysms: Signifi cance of Long-Term Monitoring ofIntracranial Pressure T. SHIGENO, K. ARITAKE, I. SAITO, and K. SANO. . . . . . . . . . . . . 235 Alterations of CSF Hydrodynamics Following Meningitis and Subarachnoid Hemor rhage U. FUHRMEISTER, P. RUETHER, D. DOMMASCH, and M. GAAB . . . . . . . . 241 Impaired Absorption of CSF During Experimental Subarachnoid Hemorrhage: Effects of Blood Components on Vesicular Transport in Arachnoid Villi A. B. BUTLER, C. J. MAFFEO, R. N. JOHNSON, and N. H. BASS . . . . . . . . 245 Session V. Brain Edema Chairman: K. SHULMAN; Co-chairman: C. P. MCGRAW Summary .............. . 251 The Time Course of Brain Tissue Compliance and Resistance in a Controlled Model of Brain Edema G. W ALSTRA, H. TAKAGI, A. MARMAROU, K. SHAPIRO, and K. SHULMAN. . . . . 253 The Role of Brain Tissue Pressure in Autoregulation of CBF in Areas of Brain Edema A. MARMAROU,H. TAKAGI, G. WALsTRA,andK. SHULMAN. . . . . . . . . 257 Quantified Regional Cerebral Glucose Consumption, rCBF and Edema, and the Effects of Papaverine, in Cats with Cortical Cold Injury A. R. DICK, S. R. NELSON, and P. L. TURNER. . . . . . . . . . . . . . 261 Evolution ofIntracranial Pressure and Cerebral Blood Flow in Cryogenic CerebralEdema R. GARCIA DE SOLA, 1. VAQUERO, J. CABEZUDO, and G. BRAVO. . . . . . . . 268 The Response to Multiple Therapeutic Modalities in Experimental Vasogenic Edema H. E. JAMES, R. D. HARBAUGH, L. F. MARSHALL, H. M. SHAPIRO, and R. LAURIN 272 Decompressive Craniectomy, ICP and Brain Edema P. R. COOPER, H. HAGLER, and W. CLARK 277 XII Intracranial Pressure and Brain Water Content in Acute Graded Experimental Cerebral Trauma R. L. CORALES, J. D. MILLER, and D. P. BEcKER . 280 Brain Edema in Ischemic Stroke and Air Embolism J. H. GARCIA and K. A. CONGER. . . . . . 284 CSF-Pressure of Rats During Ventriculo-Cisternal Perfusion with Potential Brain Edema Factors A. BAETHMANN, W. OTTINGER, W. ROTHENFUSSER, O. KEMPSKI, and A. UNTERBERG 291 ICP Changes Following Sudden Decompression of the Cat Brain Z. CZERNICKI . . . . . . . . . . . . . . . . . . . . . . . . 298 Different Aspects of a New Model of Intracranial Hypertension on the Dog Induced by a Blood Shift D. MESANGEAU, J. LEPAGNOL, and M. Au ROUSSEAU . . . . . . . . . . . 302 Brain Free Fatty Acids After Transient Global Brain Ischemia with Postinsult Thiopental Therapy E. M. NEMoTo,G. K. SHlU,J. R. GILBERTsoN,and H. ALEXANDER. . . . . . . 307 An Autoradiographic Study of Capillary Permeability During Hyperosmotic Opening J. GAZENDAM,R. G.BLASBERG,C. S. PATLAK,J. D. FENsTERMAcHER,andS.I.RAPoPoRT 312 Freeze Lesion of the Cerebrum: Local Capillary Permeability, Blood Flow and Bulk Flow of Edema Fluid R. BLASBERG, 1. GAZENDAM, C. PATLAK, and 1. FENsTERMAcHER . . . . . . . 314 Inhibition of Oxygen Diffusion as a Major Cause of Prolonged Cell Anoxia and Post ischemic ICP Elevation W. ERDMANN,J.W.F. BEKs,M. BELOPAVLOVIC,P.J. SALT,S. AGosToN,andA.BucHTHAL 317 Session VI. Systemic Factors and Infectious Processes Chairman: J. W. F. BEKs; Co-chairman: A. CROCKARD Summary .............. . 325 Systemic Vasopressor Responses and the Arterial Hypoxemia Associated with Increased Intracranial Pressure D. H. WOOD, R. M. MILLIS, and C. O. TRouTH . . . . . . . . . . . . . 327 Sequential Hemodynamic Changes in Experimental Neurogenic Pulmonary Edema M. C. NISHIMURA and J. T. HOFF. . . . . . . . . . . . . . . . . . 333 Separate and Combined Effects on Intracranial Pressure of Changes in P02 and PC02 S.JENNETTandJ.B.NoRTH. . . . . . . . . . . . . . . . . . . . 337 The Role of the Hypothalamo-Hypophysial Neurosecretory Adrenergic System in Cush- ing Reflex Z. M. RAP, L. KROLICKI, and K. SKOLASINSKA . . . . . . . . . . . . . 340 Intracranial Pressure, Brain Edema and Regional Metabolism in Experimental Brain Abscess in Cats TH. WALLENFANG,J. BOHL,M. MAYER,andK. SCHURMANN. . . ...... 344 Bacterial Meningitis: Changes in Cerebrospinal Fluid Outflow Resistance R. G. DACEY, 1. E. WELSH, W. M. SCHELD, H. R. WINN, M. A. SANDE, and 1. A. JANE 350 Experiences with ICP Monitoring in India K. L. M. KRISHNAN . . . . . . . . . . . . . . . . . . . . . . 354 XIII
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