Summary
On the basis of a series of 75 patients, the practical use of ICP continuous long-term recording in severe head injuries without mass lesions or remaining deeply comatose after surgical procedures is critically analyzed. ICP monitoring alone seems to be not essential for prognosis. Conversely it is of much greater use as a guide to management (respirator treatment, osmotics, CSF drainage). If the pros and cons of the procedure are carefully weighed, it would appear that, for the time being, ICP long-term monitoring is justified only in comatose patients on intensive care.
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Adams, H., Graham, D. I., The relationship between ventricular fluid pressure and the neuropathology of the raised intracranial pressure. In: Intracranial Pressure I, pp. 250–253 (Brock, M., Dietz, H., eds.). Berlin-Heidelberg-New York: Springer. 1972.
Becker, D. P., Vries, J. K., Young, H. F., Ward, J. D., Controlled cerebral perfusion pressure in human mechanic brain injury: prevention of progressive brain swelling. In: Intracranial Pressure II, pp. 480–484 (Lundberg, N., Ponten, U., Brock, M., eds.). Berlin-Heidelberg-New York: Springer. 1975.
Bruce, D. A., Langfitt, T. W., Miller, J. D., Schutz, H., Vapalahti, M., Stanek, A., Golberg, H. I., Regional cerebral blood flow, intracranial pressure and brain metabolism in comatose patients. J. Neurosurg.38 (1973), 131–144.
Cold, G., Enevoldsen, E., Malmros, R., The prognostic value of continuous intraventricular pressure recording in unconscious brain-injury patients under controlled ventilation. In: Intracranial Pressure II, pp. 517–521 (Lundberg, N., Ponten, U., Brock, M., eds.). Berlin-Heidelberg-New York: Springer. 1975.
Collice, M., Porta, M., Boselli, L., Rossanda, M., Enregistrement continues de la pression ventriculaire dans les traumatismes craniens graves. Neurochirurgie20 (1974), 617–622.
Crockard, H. R., Early intracranial pressure studies in gunshot wounds of the brain. J. Trauma15 (1974), 339–347.
Crockard, H. R., Coppel, D. L., Morrow, F. K., Evaluation of hyperventilation in treatment of head injuries. Brit. Med. J.4 (1973), 634–640.
De Rougemont, J., Discussion in “Intracranial pressure in clinical practice”. Workshop, Ancona, May 15–17, 1975. Journal of Neurosurg. Sci.20 (1976), 269.
De Rougemont, J., Barge, M., Benabid, A. L., Correlative study of intracranial and systemic arterial pressure in neurosurgical patients. In: Intracranial Pressure I, pp. 232–238 (Brock, M., Dietz, H., eds.). Berlin-Heidelberg-New York: Springer. 1972.
De Rougemont, J., Barge, M., Benabid, A. L., L'enregistrement de la pression intra-crânienne dans la surveillance des traumatismes crâniens en période aigue. Observations sur nos premiers résultats. A propos de 49 observations. Neuro-Chirurgie19 (1973), 125–134.
Donaghy, R. M. P., Numoto, M., Minute by minute intracranial pressure monitoring as a guide to management of pathological intracranial pressure. In: Intracranial Pressure I, pp. 217–221 (Brock, M., Dietz, H., eds.). Berlin-Heidelberg-New York: Springer. 1972.
Enevoldsen, E., Cold, G., Jensen, F. T., Malmros, R., Dynamic changes in regional CBF, intraventricular pressure, CSF pH and lactate levels during the acute phase of head injury. J. Neurosurg.44 (1976), 191–214.
Fleischer, A. S., Payne, N. S., Tindall, G. T., Continuous monitoring of intracranial pressure in severe closed head injury without mass lesions. Surg. Neurol.6 (1976), 31–34.
Fox, J. L., Falik, J. L., Smalhoub, R. J., Neurosurgical hyponatremia: the role of inappropriate antidiuresis. J. Neurosurg.34 (1971), 506–514.
Graham, D. I., Adams, H., Doyle, D., Ischaemic brain damage in arterial boundary zones in non-missile head injuries. In: Blood Flow and Metabolism in the Brain, pp. 13–25 (Harper, M., Jennett, B., Miller, D., Rowan, J., eds.). Edinburgh-London-New York: Churchill Livingstone. 1975.
Graham, D. I., Adams, H., Ischaemic brain damage in fatal head injuries. LancetI (1971), 265–266.
Gordon, E., Controlled respiration in the management of patients with traumatic brain injuries. Acta anaesth. scand.15 (1971), 193–208.
Jennett, B., Intracranial pressure measurement in clinical practice. In: Advances in Neurosurgery, pp. 52–56 (Schürmann, K., Brock, M., Reulen, H. J., Voth, D., eds.). Berlin-Heidelberg-New York: Springer. 1973.
Jennett, B., Johnston, I. H., The uses of intracranial pressure monitoring in clinical management. In: Intracranial Pressure I, pp. 353–356 (Brock, M., Dietz, H., eds.). Berlin-Heidelberg-New York: Springer. 1972.
Johnston, I. H., Jennett, B., The place of continuous intracranial pressure monitoring in neurosurgical practice. Acta Neurochir. (Wien)29 (1973), 53–63.
Johnston, I. H., Jonston, J. A., Jennett, B., Intracranial pressure changes following head injuries. Lancetii (1970), 433–436.
Johnston, I. H., Paterson, A., Harper, A. M., Jennett, B., The effect of mannitol on intracranial pressure and cerebral blood flow. Clinical and experimental observations. In: Intracranial Pressure I, pp. 176–180 (Brock, M., Dietz, H., eds.). Berlin-Heidelberg-New York: Springer. 1972.
Kuhner, A., Roquefeuil, B., Viguie, E., Frerebeau, P. H., Perez Dominguez, E., Bazin, J., Privat, J. M., Gros, C., Influence of high and low dosages of Mannitol 25% in the therapy of cerebral edema. Comparative study with monitoring intraventricular pressure. In: Advances in Neurosurgery, pp. 81–91 (Schürmann, K., Brock, M., Reulen, H. J., Voth, D., eds.). Berlin-Heidelberg-New York: Springer. 1973.
Leech, P. J., Miller, J. D., The effect of Mannitol, steroids and hypocapnia on the intracranial Volume/Pressure response. An experimental and clinical study. In: Intracranial Pressure II, pp. 361–364 (Lundberg, N., Ponten, U., Brock, M., eds.). Berlin-Heidelberg-New York: Springer. 1975.
Lundberg, N., Continuous recording and control of ventricular fluid pressure in neurosurgical practice. Acta psychiat. Neurol. Scand. Supp.149 (1960), 1–193.
Lundberg, N., Kjallquist, A., Bien, A., Reduction of increased intracranial pressure by hyperventilation. A therapeutic aid in neurological surgery. Acta psychiat. Neurol. scand. Suppl.139 (1959), 1–64.
Lundberg, N., Troupp, H., Lorin, H., Continuous recording of the ventricular fluid pressure in patients with severe acute traumatic brain injury. J. Neurosurg.22 (1965), 581–590.
Miller, J. D., Discussion in “Intracranial pressure in clinical practice”. Workshop, Ancona, May 15–17, 1975. Journal of Neurosurg. Sci.20 (1976), 218.
Miller, J. D., Discussion in “Management of traumatic coma”. J. Neurosurg. Sci.17 (1973), 150.
Miller, J. D., Leech, P. J., Effects of mannitol and steroid therapy on intracranial volume-pressure relationships in patients. J. Neurosurg.42 (1975), 274–281.
Rossanda, M., Collice, M., Porta, M., Boselli, L., Intracranial hypertension in head injury. Clinical significance and relation to respiration. In: Intracranial Pressure II, pp. 475–479 (Lundberg, N., Ponten, U., Brock, M., eds.). Berlin-Heidelberg-New York: Springer. 1975.
Rowed, D. W., Leech, P. J., Reilly, P. L., Miller, J. D., Hypocapnia and intracranial volume-pressure relationship. Arch. Neurol. (Chicago)32 (1975), 369–373.
Shenkin, H. A., Bezier, H. S., Bouzarth, W. F., Restricted fluid intake. Rational management of the neurosurgical patient. J. Neurosurg.45 (1976), 432–436.
Tindall, G. T., McGraw, C. P., Vanderveer, R. W., Iwata, K., Cardiorespiratory changes associated with plateau waves in patients with head injury. In: Intracranial Pressure I, pp. 227–231 (Brock, M., Dietz, H., eds.). Berlin-Heidelberg-New York: Springer. 1972.
Tindall, G., Patton, J. M., Dunion, J. J., O'Brien, M. S., Monitoring in patients with head injuries. Clinical Neurosurgery22 (1975), 332–363.
Troupp, H., Kuurne, T., Kaste, M., Vapalahti, M., Valtonen, S., Intraventricular pressure after severe brain injuries; prognostic value and correlation with blood pressure and jugular venous oxygen tension. In: Intracranial Pressure I, pp. 222–226 (Brock, M., Dietz, H., eds.). Berlin-Heidelberg-New York: Springer. 1972.
Troupp, H., Vapalahti, M., Ventricular fluid pressure in children with severe brain injuries. In: Advances in Neurosurgery I, pp. 62–67 (Schürmann, K., Brock, M., Reulen, H. J., Voth, D., eds.). Berlin-Heidelberg-New York: Springer. 1973.
Vapalahti, M., Troupp, H., Prognosis for patients with severe brain injuries. Brit. Med. J.3 (1971), 404–407.
Vapalahti, M., Troupp, H., Heiskanen, O., Extremely severe brain injuries treated with hyperventilation and ventricular drainage. In: Cerebral Blood Flow, pp. 266–267 (Brock, M., Fieschi, C., Ingvar, D. H., Lassen, N. A., Schürmann, K., eds.). Berlin-Heidelberg-New York: Springer. 1969.
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Papo, I., Caruselli, G. Long-term intracranial pressure monitoring in comatose patients suffering from head injuries. A critical survey. Acta neurochir 39, 187–200 (1977). https://doi.org/10.1007/BF01406729
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DOI: https://doi.org/10.1007/BF01406729