Continuous cerebral compliance monitoring in severe head injury: its relationship with intracranial pressure and cerebral perfusion pressure

Portella, Gina; Cucerea, Manuela; Citerio, Giuseppe; Contant, Charles F.; Kiening, Karl; Enblad, Per; Piper, Ian

doi:10.1007/s00701-005-0537-z

Cited by 37 publications

(33 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Children with CP may be more susceptible to lowered CSF pressure symptoms, owing to decreased compliance of the CSF compartment. 22,23 Albright et al postulated that the increased incidence of CSF leakage during ITB therapy in children with CP might be caused by occult hydrocephalus. 24 They performed lumbar punctures in 24 children with CP and asymptomatic ventriculomegaly, resulting in abnormally high opening pressures in 23 children.…”

Section: Discussionmentioning

confidence: 99%

Intrathecal baclofen in children with spastic cerebral palsy: a double‐blind, randomized, placebo‐controlled, dose‐finding study

Hoving¹,

Raak²,

Spincemaille³

et al. 2007

Develop Med Child Neuro

View full text Add to dashboard Cite

Intrathecal baclofen (ITB) therapy can be very effective in the treatment of intractable spasticity, but its effectiveness and safety have not yet been thoroughly studied in children with cerebral palsy (CP). The aims of this double‐blind, randomized, placebo‐controlled, dose‐finding study were to select children eligible for continuous ITB infusion, to assess the effective ITB bolus dose, and to evaluate the effects, side effects, and complications. Outcome measures included the original Ashworth scale and the Visual Analogue Scale for individually formulated problems. We studied nine females and eight males, aged between 7 and 16 years (mean age 13y 2mo [SD 2y 9mo]). Twelve children had spastic CP and five had spastic‐dyskinetic CP. One child was classified on the Gross Motor Function Classification System at Level III, two at Level I V, and 14 at Level V. The test treatment worked successfully for all 17 children with an effective ITB bolus dose of 12.5μg in one, 20μg in another, 25μg in 10, and 50μg in five children. ITB significantly reduced muscle tone, diminished pain, and facilitated ease of care. The placebo did not have these effects. Nine side effects of ITB were registered, including slight lethargy in seven children. Fourteen children had symptoms of lowered cerebrospinal fluid pressure. We conclude that ITB bolus administration is effective and safe for carefully selected children with intractable spastic CP.

show abstract

Section: Discussionmentioning

confidence: 99%

Intrathecal baclofen in children with spastic cerebral palsy: a double‐blind, randomized, placebo‐controlled, dose‐finding study

Hoving¹,

Raak²,

Spincemaille³

et al. 2007

Develop Med Child Neuro

View full text Add to dashboard Cite

show abstract

“…9 The intracranial compliance expresses the volume distensibility of the intracranial tissue, that is, the capability to dampen the volume increase resulting from arterial inflow into the cranium to prevent a rise in ICP. 10,11 It can be determined from the net transcranial blood flow, CSF flow, and spinal cord displacement as measured by PC cine MRI. 9,12 This MRI-based noninvasive measurement of intracranial compliance and pressure has also been applied to the diagnosis of iNPH and has been used to demonstrate that the intracranial compliance in patients with iNPH is reduced, 9,13 leading to tight mechanical coupling between blood flow and CSF pulsation in the cardiac cycle.…”

Section: Introductionmentioning

confidence: 99%

Technical Note: Development of a cranial phantom for assessing perfusion, diffusion, and biomechanics

et al. 2017

View full text Add to dashboard Cite

show abstract

“…[1] However, even the latest hydrodynamic theory fails to fully explain the pathophysiology underlying communicating hydrocephalus such as post-trauma, post-meningitis or post-subarachnoid hemorrhage ventriculomegaly with and without hydrocephalus, and normal pressure hydrocephalus (NPH) and its related disorders. For this reason, we revisit the old concept of brain buoyancy from the perspective of “microgravity or weightlessness intracranial space” and propose a wider concept called “anatomical and physiological compensatory-decompensatory phases for persistent raise in intracranial pressure (ICP).” Deduce together with known and accepted concepts of brain pulsation,[12] brain elasticity and compliance,[345] cerebral autoregulation,[67] blood-brain barrier,[7] cerebral perfusion pressure (CPP) and ischemia,[89] cerebral blood flow (CBF),[1011] ICP, and venous hypertension,[1213] we motion plausible mechanisms that underlie ventriculomegaly with and without hydrocephalus. In addition, we also highlight the concept of “microgravity–gravity interface” in human body to relate the importance of this interaction to maintain brain and body homeostasis.…”

Section: Introductionmentioning

confidence: 99%

Microgravity environment and compensatory: Decompensatory phases for intracranial hypertension form new perspectives to explain mechanism underlying communicating hydrocephalus and its related disorders

2014

View full text Add to dashboard Cite

The pathogenesis underlying communicating hydrocephalus has been centered on impaired cerebrospinal fluid (CSF) outflow secondary to abnormal CSF pulsation and venous hypertension. Hydrodynamic theory of hydrocephalus fares better than traditional theory in explaining the possible mechanisms underlying communicating hydrocephalus. Nonetheless, hydrodynamic theory alone could not fully explain some conditions that have ventriculomegaly but without hydrocephalus. By revisiting brain buoyancy from a fresher perspective, called microgravity environment of the brain, introducing wider concepts of anatomical and physiological compensatory–decompensatory phases for a persistent raise in intracranial pressure, and along with combining these two concepts with the previously well-accepted concepts of Monro–Kellie doctrine, intracranial hypertension, cerebral blood flow, cerebral perfusion pressure, brain compliance and elasticity, cerebral autoregulation, blood–brain and blood–CSF barriers, venous and cardiopulmonary hypertension, Windkessel phenomenon, and cerebral pulsation, we provide plausible explanations to the pathogenesis for communicating hydrocephalus and its related disorders.

show abstract

Continuous cerebral compliance monitoring in severe head injury: its relationship with intracranial pressure and cerebral perfusion pressure

Abstract: Low CPP levels are confirmed to be detrimental for intracranial compliance. Moreover, when ICP was pathological, indicating unstable intracranial equilibrium, a high CPP level was also associated with a low volume-buffering capacity.

Cited by 37 publications

References 23 publications

Intrathecal baclofen in children with spastic cerebral palsy: a double‐blind, randomized, placebo‐controlled, dose‐finding study

Intrathecal baclofen in children with spastic cerebral palsy: a double‐blind, randomized, placebo‐controlled, dose‐finding study

Technical Note: Development of a cranial phantom for assessing perfusion, diffusion, and biomechanics

Microgravity environment and compensatory: Decompensatory phases for intracranial hypertension form new perspectives to explain mechanism underlying communicating hydrocephalus and its related disorders

Contact Info

Product

Resources

About