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) • continual grownup Hydrocephalus (J. Philippon, D. Ancri) • surgical procedure of Craniostenosis in complicated circumstances. a style of intensive 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 twine Tumors (B. Guidetti)
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Patient reacted for pain only. Systolic arterial pressure in mm Hg is given below the VFP tracing. w. /min was given intravenously. Good initial VFP reduction followed by a progressive VFP increase above 110 mm Hg. Collaps of the ventricle prevented CSF drainage. Rapid infusion of mannitol was without effect. VFP decrease occurred simultaneously with a fall in blood pressure indicating total brain ischemia. o i§o ~ eo eo f g, t i· ,g 38 N. : of VFP reduction is illustrated in Fig. 19. Slow infusions around 5 mg/kg b.
G. psychomotor agitation, forced breathing, decerebration or epileptic seizures. It is a matter of course that all kinds of respiratory-depressing drugs are prohibited in these cases unless the patient is artificially ventilated. ). There are strong reasons to believe that in such a situation the brain has a low tolerance to fall in blood pressure. e. the fall in blood pressure which occurs when an intracranial hypertension passes from a compensated into an incompensated state and the cerebral blood circulation ceases.
The influence of hyperventilation on intracranial hypertension and its clinical application has been extensively studied during the last 15 years. On the basis of a clinical study, Lundberg et al. (1959) suggested that hyperventilation is a useful aid for reducing ICP in patients with intracranial hypertension both in acute situations and as a long term treatment. However, controversy still exists as to the efficiency and possible sideeffects of induced hyperventilation. a) Mode of Action and Effect on ICP The mode of action of hyperventilation in reducing ICP may be briefly summarized as follows.
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.)