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intra-cerebral pressure

Rodney A Gabriel, Anair Beverly, Richard P Dutton, Richard D Urman
Total shoulder arthroplasty (TSA) is typically performed in the beach-chair position. Maintenance of adequate mean arterial pressure is required to provide appropriate cerebral perfusion pressure and prevent cerebral ischemia. Placement of an arterial line to facilitate invasive monitoring is discretionary, based on clinical judgment. We aimed to describe patient, surgical and institutional factors associated with the current use of blood pressure monitoring via an arterial line for TSA. We used de-identified patient data from the National Anesthesia Clinical Outcomes Registry between 2010 and 2015 to identify patients undergoing TSA under general anesthesia...
October 13, 2016: Journal of Clinical Monitoring and Computing
J Scott Pannell, David R Santiago-Dieppa, Arvin R Wali, Brian R Hirshman, Jeffrey A Steinberg, Vincent J Cheung, David Oveisi, Jon Hallstrom, Alexander A Khalessi
This study establishes performance metrics for angiography and neuroendovascular surgery procedures based on longitudinal improvement in individual trainees with differing levels of training and experience. Over the course of 30 days, five trainees performed 10 diagnostic angiograms, coiled 10 carotid terminus aneurysms in the setting of subarachnoid hemorrhage, and performed 10 left middle cerebral artery embolectomies on a Simbionix Angio Mentor™ simulator. All procedures were nonconsecutive. Total procedure time, fluoroscopy time, contrast dose, heart rate, blood pressures, medications administered, packing densities, the number of coils used, and the number of stent-retriever passes were recorded...
August 29, 2016: Curēus
Deepak Kumar Gupta, Ajay Bisht, Priyam Batra, Purva Mathur, Ashok Kumar Mahapatra
BACKGROUND: The management of traumatic brain injury (TBI) aims to maintain the normal cerebral perfusion in spite of the mass lesions that may occur (haematoma, contusion, and oedema). The monitoring of the intracranial pressure (ICP) is a step in that direction. The intra-parenchymal catheters have the lowest incidence of infection compared to intra-ventricular/subdural catheters with reliable and accurate pressure recordings. The major disadvantage of the intra-parenchymal catheters is the cost, especially in developing nations...
October 2016: Asian Journal of Neurosurgery
Simona Lattanzi, Mauro Silvestrini
No abstract text is available yet for this article.
August 2016: Annals of Translational Medicine
Natasha Bray, Fiona E Burrows, Myles Jones, Jason Berwick, Stuart M Allan, Ingo Schiessl
BACKGROUND: Neurovascular coupling describes the mechanism by which the energy and oxygen demand arising from neuronal activity is met by an increase in regional blood flow, known as the haemodynamic response. Interleukin 1 (IL-1) is a pro-inflammatory cytokine and an important mediator of neuronal injury, though mechanisms through which IL-1 exerts its effects in the brain are not fully understood. In this study, we set out to investigate if increased cerebral levels of IL-1 have a negative effect on the neurovascular coupling in the cortex in response to sensory stimulation...
2016: Journal of Neuroinflammation
Edoardo Picetti, Franco Servadei, Cristiana Reverberi, Francesca De Carlo, Ilaria Rossi, Marta Velia Antonini, Maria Luisa Caspani
BACKGROUND: The aim of this prospective clinical study was to evaluate the cerebral and hemodynamic effects of low dose intramuscular DCFS administered for fever control in ICU patients with ABI. METHODS: Inclusion criteria were: 1) age ≥ 18 years, 2) the ability to monitor intra-arterial blood pressure, Tc, and ICP, 3) the placement of an indwelling jugular venous catheter for intermittent SjVO2 measurements, and 4) a Tc ≥ 37.5 °C. Exclusion criteria were: hypovolemia, administration of drugs with hemodynamic effects during the study period, administration of antipyretics within 6 hours prior to the start of the study, acute heart failure, cerebral vasospasm, pregnancy, renal and gastric diseases and allergy to DCFS...
August 17, 2016: World Neurosurgery
Fawaz Al-Mufti, Nicholas Morris, Shouri Lahiri, William Roth, Jens Witsch, Iona Machado, Sachin Agarwal, Soojin Park, Philip M Meyers, E Sander Connolly, Jan Claassen
INTRODUCTION: Intra-aortic counterpulsation balloon pumps (IABPs) have been widely used to augment hemodynamics in critically ill patients with cardiogenic shock and have recently been proposed as a management strategy for subarachnoid hemorrhage (SAH) patients with neurogenic stress cardiomyopathy (NSC). Prior case series have described the use of IABP as a means to manage cardiogenic shock in this patient population; however, we sought to describe our experience with IABP as a means to wean vasopressor requirement while augmenting hemodynamics and maintaining pressures at goal...
June 2016: Journal of Vascular and Interventional Neurology
Yuanliang Jiang, Wenjia Peng, Zhongzhao Teng, Jonathan H Gillard, Bo Hong, Qi Liu, Jianping Lu
The mechanism underlying atherosclerotic ischemic events within the middle cerebral artery (MCA) is unclear. High structural stress induced by blood pressure might be a potential aetiology as plaque rupture occurs when such mechanical loading exceeds its material strength. To perform reliable analyses quantifying the mechanical loading within a plaque, the local blood pressure is needed. However, data on MCA blood pressure is currently lacking. In this study, the arterial pressure proximal to the stenotic site in the MCA was measured in 15 patients scheduled for intervention...
2016: Biomedical Engineering Online
Umberto Marcello Bracale, Flavia Spalla, Federica Caioni, Domenico Solari, Donatella Narese, Felice Pecoraro, Luca Del Guercio
UNLABELLED: In the management of severe carotid artery stenosis particular importance must be given to the evaluation of the risk of perioperative cerebral ischemic events. Our study analysed the possible relationship between the pre-operative middle cerebral artery Gosling Index, calculated after transcranial Doppler (TCD), and intra-operative stump pressure (SP), in order to identify patients with higher risk of ischemic accidents. Moreover, we studied pre- and post- operative Gosling Index values in association with possible events during follow-up...
2016: Annali Italiani di Chirurgia
(no author information available yet)
No abstract text is available yet for this article.
June 2016: Annals of Intensive Care
Gloria Pelizzo, Luciano Bernardi, Veronica Carlini, Noemi Pasqua, Simonetta Mencherini, Giuseppe Maggio, Annalisa De Silvestri, Lucio Bianchi, Valeria Calcaterra
BACKGROUND: The systemic impact of intra-abdominal pressure (IAP) and/or changes in carbon dioxide (CO 2) during laparoscopy are not yet well defined. Changes in brain oxygenation have been reported as a possible cause of cerebral hypotension and perfusion. The side effects of anaesthesia could also be involved in these changes, especially in children. To date, no data have been reported on brain oxygenation during routine laparoscopy in paediatric patients. PATIENTS AND METHODS: Brain and peripheral oxygenation were investigated in 10 children (8 male, 2 female) who underwent elective minimally invasive surgery for inguinal hernia repair...
May 5, 2016: Journal of Minimal Access Surgery
Akimasa Morisaki, Mitsuharu Hosono, Takashi Murakami, Masanori Sakaguchi, Yasuo Suehiro, Shinsuke Nishimura, Yoshito Sakon, Daisuke Yasumizu, Takumi Kawase, Toshihiko Shibata
OBJECTIVES: Deep sternal wound infection (DSWI) after cardiovascular surgery via median sternotomy remains a severe complication associated with a drastic decrease in the quality of life. We assessed the risk factors for in-hospital death caused by DSWI and the available treatments for DSWI. METHODS: Between January 1991 and August 2015, we retrospectively reviewed 73 patients (51 males and 22 females, mean age 67.5 ± 10.3 years) who developed DSWI after cardiovascular surgery via median sternotomy...
September 2016: Interactive Cardiovascular and Thoracic Surgery
Fiona D McBryde, Simon C Malpas, Julian Fr Paton
The brain is an exceptionally energetically demanding organ with little metabolic reserve, and multiple systems operate to protect and preserve the brain blood supply. But how does the brain sense its own perfusion? In this review, we discuss how the brain may harness the cardiovascular system to counter threats to cerebral perfusion sensed via intracranial pressure (ICP), cerebral oxygenation and ischemia. Since the work of Cushing over 100 years ago, the existence of brain baroreceptors capable of eliciting increases in sympathetic outflow and blood pressure has been hypothesized...
May 12, 2016: Acta Physiologica
Seby John, Walaa Hazaa, Ken Uchino, Muhammad S Hussain
BACKGROUND: There is sparse literature on the natural history of blood pressure (BP) after intra-arterial therapy (IAT) for acute ischemic stroke (AIS). METHODS: A retrospective analysis was performed of patients with AIS who underwent IAT without endotracheal intubation for internal carotid artery terminus (ICA-T) or M1 middle cerebral artery occlusion from January 2008 to February 2012. Systolic BP (SBP) values at the beginning (First) and end (End) of IAT and for 36 h after the procedure were collected...
April 15, 2016: Journal of Neurointerventional Surgery
Wei-guo Liao, Li-sheng Wang, Wen-tao Fan, Zhou Li, Jian-ye Yu, Feng-yun Liao, Yin-ai Wu, Wen-qiang Ba, Ding Wang
To establish a method for detecting microdialysis recovery of tetramethylpyrazine (TMP) and ferulic acid (FA) and investigating the influencing factors, providing the basis for further in vivo microdialysis experiments. The concentration of FA and TMP in dialysates were determined by high pressure liquid chromatography ( HPLC) and probe recovery were calculated respectively. The influence of the flow rates, medium concentration, temperature and in vivo probe stability on the recovery of FA and TMP were investigated by using concentration difference method (incremental method and decrement method)...
November 2015: Zhongguo Zhong Yao za Zhi, Zhongguo Zhongyao Zazhi, China Journal of Chinese Materia Medica
Debasis Sahoo, Caroline Deck, Rémy Willinger
Traumatic brain injury (TBI) is the leading cause of death and permanent impairment over the last decades. In both the severe and mild TBIs, diffuse axonal injury (DAI) is the most common pathology and leads to axonal degeneration. Computation of axonal strain by using finite element head model in numerical simulation can enlighten the DAI mechanism and help to establish advanced head injury criteria. The main objective of this study is to develop a brain injury criterion based on computation of axonal strain...
July 2016: Accident; Analysis and Prevention
You-Sub Kim, Sung-Hyun Kim, Seung-Hoon Jung, Tae-Sun Kim, Sung-Pil Joo
BACKGROUND: A lumbar drainage catheter is frequently placed intra-operatively to decrease fluid pressure on the brain in aneurysmal subarachnoid cases. In rare cases, this catheter placement can lead to intracranial hypotension, resulting in brain stem herniation termed "brain sag" and it can lead to neurological injury and may prove to be fatal. We present our patient with brain sag secondary to intraoperative lumbar drainage. CASE DESCRIPTION: A 56-year-old woman was admitted with a sudden onset of severe headache...
2016: SpringerPlus
William Bernal, Nicholas Murphy, Sarah Brown, Tony Whitehouse, Peter Nissen Bjerring, John Hauerberg, Hans J Frederiksen, Georg Auzinger, Julia Wendon, Fin Stolze Larsen
BACKGROUND & AIMS: Animal models and human case series of acute liver failure (ALF) suggest moderate hypothermia (MH) to have protective effects against cerebral oedema (CO) development and intracranial hypertension (ICH). However, the optimum temperature for patient management is unknown. In a prospective randomized controlled trial we investigated if maintenance of MH prevented development of ICH in ALF patients at high risk of the complication. METHODS: Patients with ALF, high-grade encephalopathy and intracranial pressure (ICP) monitoring in specialist intensive care units were randomized by sealed envelope to targeted temperature management (TTM) groups of 34°C (MH) or 36°C (control) for a period of 72h...
August 2016: Journal of Hepatology
David Cioncoloni, Deborah Rosignoli, Matteo Feurra, Simone Rossi, Marco Bonifazi, Alessandro Rossi, Riccardo Mazzocchio
Most of the cerebral functions are asymmetrically represented in the two hemispheres. Moreover, dexterity and coordination of the distal segment of the dominant limbs depend on cortico-motor lateralization. In this study, we investigated whether postural control may be also considered a lateralized hemispheric brain function. To this aim, 15 young subjects were tested in standing position by measuring center of pressure (COP) shifts along the anteroposterior axis (COP-Y) during dynamic posturography before and after continuous Theta Burst Stimulation (cTBS) intervention applied to the dominant or non-dominant M1 hand area as well as to the vertex...
July 2016: Experimental Brain Research. Experimentelle Hirnforschung. Expérimentation Cérébrale
Go Un Roh, Won Oak Kim, Koon Ho Rha, Byung Ho Lee, Hae Won Jeong, Sungwon Na
Internal jugular vein (IJV) is the main pathway of cerebral venous drainage and its valves prevent regurgitation of blood to the brain. IJV valve incompetence (IJVVI) is known to be associated with cerebral dysfunctions. It occurs more often in male over 50 years old, conditions elevating intra-abdominal or intra-thoracic pressure. In robot-assisted laparoscopic radical prostatectomy (RALRP), elderly male undergoes surgery in Trendelenburg position with pneumoperitoneum applied. Therefore, we assessed the IJVVI during RALRP and its influence on postoperative cognitive function...
May 2016: Archives of Gerontology and Geriatrics
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