The major influence of the atmosphere on intracranial pressure: an observational study

Herbowski, Leszek

doi:10.1007/s00484-016-1202-3

Cited by 7 publications

(4 citation statements)

References 13 publications

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“…Imbalance of atmospheric pressure and ICP, disruption of CSF flow dynamics, and disruption of CBF and metabolism have been postulated to cause SoT 6–11,18,33. Under normal physiological conditions atmospheric pressure correlates with intracranial pressure with barometric changes usually insufficient to affect intracranial physiology significantly due to the protective effect of the calvarium 34. Epidural pressure monitoring of postcraniectomy patients with large skull defects undergoing cranioplasty demonstrates initially elevated ICPs preoperatively in a subset of patient with reversable neurological deficits 10.…”

Section: Discussionmentioning

confidence: 99%

Systematic Review of Syndrome of the Trephined and Reconstructive Implications

Mustroph¹,

Stewart

Mann³

et al. 2022

Journal of Craniofacial Surgery

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Syndrome of the trephined (SoT) is a severe complication following decompressive craniectomy resulting in neurological decline which can progress to aphasia, catatonia, and even death. While cranioplasty can reverse neurological symptoms of SoT, awareness of SoT is poor outside of the neurosurgery community. The authors performed a systematic review of the literature on SoT with a focus on reconstructive implications. Search terms “syndrome of the trephined” and “sunken flap syndrome” were applied to PubMed to identify primary studies through October 2021. Full-text review yielded 11 articles discussing SoT and reconstructive techniques or implications with 56 patients undergoing cranial reconstruction. Average age of the patients was 41.8±9.5 years. Sixty-three percent of the patients were male. The most common indication for craniectomy was traumatic brain injury (43%), followed by tumor resection (23%), intracerebral hemorrhage (11%), and aneurysmal subarachnoid hemorrhage (2%). Patients most commonly suffered from motor deficits (52%), decreased wakefulness (30%), depression or anxiety (21%), speech deficits (16%), headache (16%), and cognitive difficulties (2%). Time until presentation of symptoms following decompression was 4.4±8.9 months. Patients typically underwent cranioplasty with polyetheretherketone (48%), titanium mesh (21%), split thickness calvarial bone (16%), full thickness calvarial bone (14%), or split thickness rib graft (4%). Eight percent of patients required free tissue transfer for soft tissue coverage. Traumatic Brain Injury (TBI) was a risk factor for development of SoT when adjusting for age and sex (odds ratio: 8.2, 95% confidence interval: 1.2–8.9). No difference significant difference was observed between length until initial improvement of neurological symptoms following autologous versus allograft reconstruction (P=0.47). SoT can be a neurologically devastating complication of decompressive craniectomy which can resolve following urgent cranioplasty. Familiarity with this syndrome and its reconstructive implications is critical for the plastic surgery provider, who may be called upon to assist with these urgent cases.

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Section: Discussionmentioning

confidence: 99%

Systematic Review of Syndrome of the Trephined and Reconstructive Implications

Mustroph¹,

Stewart

Mann³

et al. 2022

Journal of Craniofacial Surgery

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“…There is a significant number of published papers showing some kind of association between atmospheric pressure change and SAH incidence, probably because papers with negative results are rarely published, as pointed previously 31 . Furthermore, several authors speculate that atmospheric pressure may affect blood or intracranial pressure, leading to possible IA rupture 40,42 . Still, at this time, there is no satisfactory explanation for the association between atmospheric pressure changes and SAH.…”

Section: Discussionmentioning

confidence: 99%

Meteorological Variables Associated with Subarachnoid Hemorrhage: A Single Center Study

Rotim

2022

ACC

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Spontaneous subarachnoid hemorrhage (SAH) can occur unexpectedly and independently of the classic risk factors. Several different factors could affect intracranial aneurysm (IA) rupture, such as morphological and hemodynamic factors. The aim of this study was to establish the potential association of meteorological data such as temperature, atmospheric pressure, and humidity, and the onset of clinical symptoms preceding hospital admission of patients with acute SAH due to IA rupture. This retrospective study included 130 consecutive patients admitted for non-traumatic SAH with a determinable onset of SAH symptoms. The effects of meteorological parameters of atmospheric pressure, ambient temperature, and relative air humidity on the day of acute SAH onset and 24 hours prior to the onset of symptoms were recorded and analyzed in each patient. Spearman rank correlation analysis was used to assess the risks of incident SAH on the basis of daily meteorological data. Seasonal incidence of acute SAH showed the peak incidence in winter and a trough in summer, with monthly incidence peak in January and December. The circadian rhythm analysis showed the peak incidence of SAH in the forenoon, followed by the evening. Acute SAH incidence showed moderate positive association with daily atmospheric pressure (p<0.05), while no association was found with ambient temperature and relative air humidity. Our results suggested no significant association of changes in ambient temperature and relative humidity with the risk of SAH. Increases in atmospheric pressure were weakly associated with a higher SAH risk. Additional studies are needed to establish in detail both meteorological and morphological factors important to predict IA rupture and SAH.

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“…Some studies suggested that climate or the Moon may influence humans and animals and the occurrence of various diseases [8][9][10]. A prospective study suggested that atmospheric pressure positively impacts absolute intracranial pressure in humans [11]. More specifically, some authors suggested a role of climate conditions in intracerebral hemorrhage and SAH [12][13][14][15][16][17][18], but reported conflicting results.…”

Section: Introductionmentioning

confidence: 99%