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https://www.readbyqxmd.com/read/30074450/intraoperative-intracranial-pressure-monitoring-in-the-pediatric-craniosynostosis-population
#1
Brendan F Judy, Jordan W Swanson, Wuyang Yang, Phillip B Storm, Scott P Bartlett, Jesse A Taylor, Gregory G Heuer, Shih-Shan Lang
OBJECTIVE Evaluation of increased intracranial pressure (ICP) in the pediatric craniosynostosis population based solely on ophthalmological, clinical, and radiographic data is subjective, insensitive, and inconsistent. The aim of this study was to examine the intraoperative ICP before and after craniectomy in this patient population. METHODS The authors measured the ICP before and after craniectomy using a subdural ICP monitor in 45 children. They regulated end-tidal carbon dioxide and the monitoring site under general anesthesia to record consistent ICP readings...
August 3, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/30055363/intracranial-hypotension-with-coma-microsurgical-repair-of-a-spinal-ventral-dural-tear-and-drainage-of-subdural-hematoma-with-intracranial-pressure-monitoring
#2
Keisuke Takai, Makoto Taniguchi
BACKGROUND: Difficulties are associated with the diagnosis and management of patients with coma due to intracranial hypotension. CASE DESCRIPTION: The authors describe the case of a 70-year-old male with coma (Glasgow Coma Scale of 6) with fixed dilated pupils due to severe intracranial hypotension. After unsuccessful epidural blood patch (EBP), the patient underwent microsurgical dural repair and drainage of hematoma with intracranial pressure (ICP) monitoring...
July 25, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/30053135/patients-who-benefit-from-intracranial-pressure-monitoring-without-cerebrospinal-fluid-drainage-after-severe-traumatic-brain-injury
#3
(no author information available yet)
BACKGROUND: India has a high traumatic brain injury (TBI) burden and intracranial pressure monitoring (ICP) remains controversial but some patients may benefit. OBJECTIVE: To examine the association between ICP monitor placement and outcomes, and identify Indian patients with severe TBI who benefit from ICP monitoring. METHODS: We conducted a secondary analysis of a prospective cohort study at a level 1 Indian trauma center. Patients over 18 yr with severe TBI (admission Glasgow coma scale score < 8) who received tracheal intubation for at-least 48 h were examined...
July 25, 2018: Neurosurgery
https://www.readbyqxmd.com/read/30050328/adjusting-for-confounding-by-indication-in-observational-studies-a-case-study-in-traumatic-brain-injury
#4
Maryse C Cnossen, Thomas A van Essen, Iris E Ceyisakar, Suzanne Polinder, Teuntje M Andriessen, Joukje van der Naalt, Iain Haitsma, Janneke Horn, Gaby Franschman, Pieter E Vos, Wilco C Peul, David K Menon, Andrew Ir Maas, Ewout W Steyerberg, Hester F Lingsma
Introduction: Observational studies of interventions are at risk for confounding by indication. The objective of the current study was to define the circumstances for the validity of methods to adjust for confounding by indication in observational studies. Patients and methods: We performed post hoc analyses of data prospectively collected from three European and North American traumatic brain injury studies including 1,725 patients. The effects of three interventions (intracranial pressure [ICP] monitoring, intracranial operation and primary referral) were estimated in a proportional odds regression model with the Glasgow Outcome Scale as ordinal outcome variable...
2018: Clinical Epidemiology
https://www.readbyqxmd.com/read/30031178/effect-of-hypernatremia-on-outcomes-after-severe-traumatic-brain-injury-a-nationwide-inpatient-sample-analysis
#5
Haydn Hoffman, Muhammad S Jalal, Lawrence S Chin
OBJECTIVE: Induced hypernatremia is frequently used to reduce intracranial pressure in patients with severe traumatic brain injury (TBI). This technique is controversial, and some studies have independently associated hypernatremia with worse outcomes after TBI. We sought to investigate this potential association in a large healthcare database. METHODS: The Nationwide Inpatient Sample was used to obtain data on all adults who had been discharged from 2002 to 2011 with a primary diagnosis of TBI who required mechanical ventilation, intracranial pressure monitoring, or craniotomy/craniectomy...
July 18, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/30014363/pulsatile-versus-non-pulsatile-tinnitus-in-idiopathic-intracranial-hypertension
#6
Jonathan P Funnell, Claudia L Craven, Simon D Thompson, Linda D'Antona, Aswin Chari, Lewis Thorne, Laurence D Watkins, Ahmed K Toma
INTRODUCTION: Tinnitus is a symptom commonly associated with idiopathic intracranial hypertension (IIH) that can have a profound effect on quality of life. We aim to determine tinnitus symptom response after dural venous sinus stenting (DVSS) or CSF diversion with a shunt, in patients with both pulsatile (PT) and non-pulsatile tinnitus (NPT). METHODS: Single-centre cohort of IIH patients (2006-2016) who underwent 24-h ICP monitoring (ICPM). An un-paired t test compared ICP and pulse amplitude (PA) values in IIH patients with PT vs...
July 16, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/30010593/implantable-wireless-intracranial-pressure-monitoring-based-on-air-pressure-sensing
#7
Hanjun Jiang, Yanshu Guo, Zeliang Wu, Chun Zhang, Wen Jia, Zhihua Wang
A wireless intracranial pressure (ICP) monitoring system based on the air pressure sensing is proposed in this work. The proposed system is composed of an implantable ICP sensing device and a portable wireless data recorder. The ICP sensing device consists of an air pressure sensor, an ultra-thin air pouch for pressure sensing, and a low-power dedicated system-on-a-chip (SoC) for the data acquisition control and wireless transmission. The SoC consists of a power management unit, a wake-up controller, the sensor interface, a wireless transmitter, and the workflow control logic...
July 16, 2018: IEEE Transactions on Biomedical Circuits and Systems
https://www.readbyqxmd.com/read/30004311/intensive-care-resources-required-to-care-for-critically-ill-children-with-focal-intracranial-infections
#8
Marlina E Lovett, Zubin S Shah, Melissa Moore-Clingenpeel, Eric Sribnick, Adam Ostendorf, Melissa G Chung, Jeffrey Leonard, Nicole F O'Brien
OBJECTIVE Focal intracranial infections such as intraparenchymal abscesses or localized infections in the epidural or subdural spaces are relatively rare infections associated with both morbidity and mortality in children. Although children with these infections frequently require surgical intervention, there is a paucity of literature describing the critical care resources required to manage these cases. This retrospective chart review was performed to evaluate the resources necessary to care for critically ill children with focal intracranial infections at the authors' institution...
July 13, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29948998/noninvasive-intracranial-pressure-assessment-in-acute-liver-failure
#9
Venkatakrishna Rajajee, Craig A Williamson, Robert J Fontana, Anthony J Courey, Parag G Patil
BACKGROUND: Elevated intracranial pressure (ICP) is an important cause of death following acute liver failure (ALF). While invasive ICP monitoring (IICPM) is most accurate, the presence of coagulopathy increases bleeding risk in ALF. Our objective was to evaluate the accuracy of three noninvasive ultrasound-based measures for the detection of concurrent ICP elevation in ALF-optic nerve sheath diameter (ONSD) using optic nerve ultrasound (ONUS); middle cerebral artery pulsatility index (PI) on transcranial Doppler (TCD); and ICP calculated from TCD flow velocities (ICPtcd) using the estimated cerebral perfusion pressure (CPPe) technique...
June 8, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29799350/introduction-of-severe-traumatic-brain-injury-care-protocol-is-associated-with-reduction-in-mortality-for-pediatric-patients-a-case-study-of-children-s-healthcare-of-atlanta-s-neurotrauma-program
#10
Andrew Reisner, Joshua J Chern, Karen Walson, Natalie Tillman, Toni Petrillo-Albarano, Eric A Sribnick, Laura S Blackwell, Zaev D Suskin, Chia-Yi Kuan, Atul Vats
OBJECTIVE Evidence shows mixed efficacy of applying guidelines for the treatment of traumatic brain injury (TBI) in children. A multidisciplinary team at a children's health system standardized intensive care unit-based TBI care using guidelines and best practices. The authors sought to investigate the impact of guideline implementation on outcomes. METHODS A multidisciplinary group developed a TBI care protocol based on published TBI treatment guidelines and consensus, which was implemented in March 2011. The authors retrospectively compared preimplementation outcomes (May 2009 to March 2011) and postimplementation outcomes (April 2011 to March 2014) among patients < 18 years of age admitted with severe TBI (Glasgow Coma Scale score ≤ 8) and potential survivability who underwent intracranial pressure (ICP) monitoring...
May 25, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29787544/a-clinical-prediction-model-for-raised-intracranial-pressure-in-patients-with-traumatic-brain-injuries
#11
J Pace, N Parry, K Vogt, R Hilsden, R Leeper, Z Markova, F Priestap, J Younan, I M Ball
BACKGROUND: Intracranial hypertension is believed to contribute to secondary brain insult in traumatically brain injured patients. Currently the diagnosis of intracranial hypertension requires intracranial monitoring or advanced imaging. Unfortunately, prehospital transport times can be prolonged, delaying time to the initial radiographic assessment. The aim of this study was to identify clinical variables associated with raised intracranial pressure (ICP) prior to the completion of neuroimaging...
April 30, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29786813/prediction-of-mortality-in-pediatric-traumatic-brain-injury-implementations-from-a-tertiary-pediatric-intensive-care-facility
#12
Ebru Atike Ongun, Oğuz Dursun
BACKGROUND: To explore the mortality risk factors of traumatic brain injury in pediatric intensive care unit admissions. METHODS: Eighty-eight children (categorized using the Glasgow Coma Scale) between September 2014 and December 2016 were analyzed. Emergency department and intensive care course, treatment strategies, axonal injury, intubation and tracheostomy rates, length of intensive care and hospitalization, Rotterdam-CT scores, injury severity scores, and PRISM-III scores were recorded...
May 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29751187/brain-trauma-foundation-guideline-compliance-results-of-a-multidisciplinary-international-survey
#13
Ryan Hirschi, Casey Rommel, Joshua Letsinger, Raminder Nirula, Gregory W J Hawryluk
BACKGROUND: Brain Trauma Foundation (BTF) guidelines reflect evidence-based best practices in management of traumatic brain injury. The aim of this study was to examine self-reported physician compliance and predictors of compliance related to BTF guidelines. METHODS: We conducted an international, multidisciplinary survey examining self-reported adherence to BTF guidelines and multiple factors potentially affecting adherence. We also surveyed intracranial pressure monitoring practices...
May 9, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29732476/critical-thresholds-for-intracranial-pressure-vary-over-time-in-non-craniectomised-traumatic-brain-injury-patients
#14
Basil Nourallah, Frederick A Zeiler, Leanne Calviello, Peter Smielewski, Marek Czosnyka, David K Menon
BACKGROUND: Intracranial pressure (ICP)- and cerebral perfusion pressure (CPP)-guided therapy is central to neurocritical care for traumatic brain injury (TBI) patients. We sought to identify time-dependent critical thresholds for mortality and unfavourable outcome for ICP and CPP in non-craniectomised TBI patients. METHODS: This is a retrospective cohort study of 355 patients with moderate-to-severe TBI who received ICP monitoring and were managed without decompressive craniectomy in a tertiary hospital neurocritical care unit...
July 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29726988/validation-of-noninvasive-absolute-intracranial-pressure-measurements-in-traumatic-brain-injury-and-intracranial-hemorrhage
#15
Jenny C Kienzler, Rolandas Zakelis, Sabrina Bäbler, Elke Remonda, Arminas Ragauskas, Javier Fandino
BACKGROUND: Increased intracranial pressure (ICP) causes secondary damage in traumatic brain injury (TBI), and intracranial hemorrhage (ICH). Current methods of ICP monitoring require surgery and carry risks of complications. OBJECTIVE: To validate a new instrument for noninvasive ICP measurement by comparing values obtained from noninvasive measurements to those from commercial implantable devices through this pilot study. METHODS: The ophthalmic artery (OA) served as a natural ICP sensor...
May 3, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/29725828/comparison-of-effect-of-dexmedetomidine-and-lidocaine-on-intracranial-and-systemic-hemodynamic-response-to-chest-physiotherapy-and-tracheal-suctioning-in-patients-with-severe-traumatic-brain-injury
#16
Shalendra Singh, Rajendra Singh Chouhan, Ashish Bindra, Nayani Radhakrishna
PURPOSE: Chest physiotherapy and tracheal suction cause sympathetic stimulation and increase heart rate (HR), mean arterial pressure (MAP) and intracranial pressure (ICP) which may have deleterious effect in the head injured. We planned to compare the effect of intravenous dexmedetomidine and lidocaine on intracerebral and systemic hemodynamic response to chest physiotherapy (CP) and tracheal suctioning (TS) in patients with severe traumatic brain injury (sTBI). METHODS: Prospective, randomized study in patients with sTBI, 18-60 years of age, undergoing mechanical ventilation and intraparenchymal ICP monitoring...
August 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29722618/noninvasive-in-ear-monitoring-of-intracranial-pressure-during-microgravity-in-parabolic-flights
#17
Paul Avan, Hervé Normand, Fabrice Giraudet, Grégory Gerenton, Pierre Denise
Among possible causes of visual impairment or headache experienced by astronauts in microgravity or postflight and that hamper their performance, elevated intracranial pressure (ICP) has been invoked but never measured for lack of noninvasive methods. The goal of this work was to test two noninvasive methods of ICP monitoring using in-ear detectors of ICP-dependent auditory responses, acoustic and electric, in acute microgravity afforded by parabolic flights. The devices detecting these responses were handheld tablets routinely used in otolaryngology for hearing diagnosis, which were customized for ICP extraction and serviceable by unskilled operators...
August 1, 2018: Journal of Applied Physiology
https://www.readbyqxmd.com/read/29717219/proteomic-differences-between-focal-and-diffuse-traumatic-brain-injury-in-human-brain-tissue
#18
Sami Abu Hamdeh, Ganna Shevchenko, Jia Mi, Sravani Musunuri, Jonas Bergquist, Niklas Marklund
The early molecular response to severe traumatic brain injury (TBI) was evaluated using biopsies of structurally normal-appearing cortex, obtained at location for intracranial pressure (ICP) monitoring, from 16 severe TBI patients. Mass spectrometry (MS; label free and stable isotope dimethyl labeling) quantitation proteomics showed a strikingly different molecular pattern in TBI in comparison to cortical biopsies from 11 idiopathic normal pressure hydrocephalus patients. Diffuse TBI showed increased expression of peptides related to neurodegeneration (Tau and Fascin, p < 0...
May 1, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29696505/intracranial-pressure-monitoring-in-diffuse-brain-injury-why-the-developing-world-needs-it-more
#19
Tarang K Vora, Sudish Karunakaran, Ajay Kumar, Anil Chiluka, Harish Srinivasan, Kanishk Parmar, Srivatsan Thirumalai Vasu, Rahul Srinivasan, H A Chandan, P S Vishnu, Lakshay Raheja
BACKGROUND: Use of ICP monitoring is considered to be part of "standard of care" in management of severe traumatic brain injury, but it is rarely used in developing countries. The authors present a study which evaluates the efficacy and outcomes of ICP monitoring at a high-volume trauma center in India. METHODS: Data on management and outcomes for 126 patients who were admitted with diffuse traumatic brain injury (GCS 3-8) were studied prospectively over an 18-month period...
June 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29648985/feasibility-of-telemetric-intracranial-pressure-monitoring-in-the-neuro-intensive-care-unit
#20
Alexander Lilja-Cyron, Jesper Kelsen, Morten Andresen, Kåre Fugleholm, Marianne Juhler
Intracranial pressure (ICP) monitoring is crucial in the management of acute neurosurgical conditions such as traumatic brain injury (TBI). However, pathological ICP may persist beyond the admission to the neuro intensive care unit (NICU). We investigated the feasibility of telemetric ICP monitoring in the NICU, as this technology provides the possibility of long-term ICP assessment beyond NICU discharge. In this prospective investigation, we implanted telemetric ICP sensors (Raumedic Neurovent-P-tel) instead of conventional, cabled ICP sensors in patients undergoing decompressive craniectomy...
July 15, 2018: Journal of Neurotrauma
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