By N. Lundberg, Å. Kjällquist, G. Kullberg, U. Pontén, G. Sundbärg (auth.), H. Krayenbühl, J. Brihaye, F. Loew, V. Logue, S. Mingrino, B. Pertuiset, L. Symon, H. Troupp, M. G. Yaşargil (eds.)
Advances: • Non-operative administration of Intracranial high blood pressure (N. Lundberg, Å. Kjällquist, G. Kullberg, U. Pontén, G. Sundbärg) • power grownup Hydrocephalus (J. Philippon, D. Ancri) • surgical procedure of Craniostenosis in complex circumstances. a mode of in depth Subperiosteal Resection of the Vault and Base of the cranium through Bone Regeneration (H. Powiertowski) • Extra-Dural Hematoma (E. Zander, R. Campiche) Technical criteria: • Supratentorial Craniotomy (B. Pertuiset) • removing of Extramedullary Benign Spinal wire Tumors (B. Guidetti)
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Extra resources for Advances and Technical Standards in Neurosurgery
However, since most experimental studies are made on undamaged brains and the results of hyperventilation studies in cerebral infarcts are not conclusive, the possibility of untoward effects of at least extreme hyperventilation in certain clinical states cannot be fully excluded. c) Recommended Treatment There are three main indications for using controlled ventilation in patients with intracranial hypertension, viz. during craniotomy under general anaesthesia, in acute incidences of intracranial hypertension and for prolonged treatment of intracranial hypertension.
Our clinical experience (see below), that the rebound is very longlasting, often six hours or more, seems to favour the first explanation but several mechanisms may be responsible for rebound after hypertonic solutions in patients with intracranial hypertension. Consideration of the mode of action of hypertonic solutions will allow some conclusions regarding the characteristics of different solutions used. The duration of the ICP reduction is essentially dependent on the time the osmotic gradient from plasma to brain fluids is upheld.
It is obvious that the setting of a desired VFP level is facilitated if drainage is combined with continuous pressure measurement. It is equally obvious that knowledge of the ventricular fluid pressure is a more reliable indication for drainage of fluid than are clinical symptoms only. Apart from intracranial infection and technical disturbances possible complications of ventricular drainage are intracranial hemorrhage and aggravation of an upward tentorial herniation or a midline shift. Intracranial hemorrhage has been attributed to evacuation of ventricular fluid by several authors (Cushing 1902, Guttman 1936, Olivecrona 1940).
Advances and Technical Standards in Neurosurgery by N. Lundberg, Å. Kjällquist, G. Kullberg, U. Pontén, G. Sundbärg (auth.), H. Krayenbühl, J. Brihaye, F. Loew, V. Logue, S. Mingrino, B. Pertuiset, L. Symon, H. Troupp, M. G. Yaşargil (eds.)