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Dominique Renier, Christian Sainte-Rose, Daniel Marchac and Jean-François Hirsch

T he need for surgery is obvious in many cases of craniosynostosis, either because the patient's family is motivated by the aesthetic problem or because the child presents clinical signs of intracranial hypertension. In other cases, especially when only one cranial suture is involved or when the child is over 3 or 4 years old, it is more difficult to make a decision whether to operate, because it is then usually impossible to infer increased intracranial pressure (ICP) from the clinical features alone. Moreover, in craniostenosis, true papilledema is uncommon

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Ballard D. Wright and Byron Young

T he clinical usefulness of intracranial pressure (ICP) monitoring has spawned a number of innovative devices and techniques. These devices measure ICP by means of sensors or transducers that are either implanted in the skull or connected to an intraventricular catheter. The calibrated output of the sensors is displayed as an electronic waveform on an oscilloscope. 1–4 These devices are properly referred to as monitors since they have no intrinsic regulating function. We are describing a device (invented by B.D.W.) that enables pressure monitoring as well as

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Keasley Welch

T he control of intracranial pressure (ICP) is perhaps the principal task in the neurosurgical care of infants. Yet little is known about the pressure during the first days, months, and years after birth, and much of the present knowledge exists only in an archival sense — forgotten but accessible to scholars. Beginning with the paper by Quincke, 48 the originator of lumbar puncture, reports have consistently placed the pressure normal for infants and children at a level considerably lower than that characteristic of adults. Values taken from the literature

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Mitsuo Numoto, James K. Wallman and R. M. Peardon Donaghy

T here have been many new developments in the field of intracranial pressure measurement (ICP) using the strain gauge technique, including implantable pressure transducers, 11 and completely implantable telemetry transducers. 1, 5, 10 These latest imaginative devices are still unsatisfactory for general use because each device has one or more of the following detrimental characteristics: an unknown baseline or zero shift, temperature instability, an electric shock hazard, excessive expense, fragility, and technical difficulties in operation and maintenance

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Warren C. Boop Jr. and Richard Knight

, anesthetic-induced changes of intracranial pressure have been studied in clinical as well as experimental situations. 2, 5, 6 It has been shown that most, if not all, of the halogenated volatile anesthetics, such as halothane, may cause an increase in intracranial pressure. Investigators have felt that this increased intracranial pressure is due to the accompanying vasodilation of cerebral blood vessels. Enflurane (Ethrane) has recently been introduced into this country and recommended by some for neuroanesthesia. 4 It is a nonflammable inhalation anesthetic agent and

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Systems analysis of intracranial pressure

Comparison with volume-pressure test and CSF-pulse amplitude analysis

Michael Chopp and Harold D. Portnoy

N eurosurgeons are well aware that simply measuring intracranial pressure (ICP) fails to differentiate those patients with intracranial hypertension who have a benign course from those who may go on to fulminating intracranial hypertension. To differentiate these patients, several investigators 15, 24 have utilized the volume-pressure test (VPT), in which the intracranial system is provoked by the rapid introduction of a small volume of fluid and the immediate change in ICP determined (volume-pressure response, VPR). The test establishes an exponential volume

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John K. Vries, Donald P. Becker and Harold F. Young

F or the past 2 years it has been our policy to monitor intracranial pressure (ICP) in all patients with severe brain injuries. This has generally been done by means of a ventricular catheter using the technique of Lundberg. 2 Unfortunately we have experienced a high rate of infection with these catheters. Moreover, we have had difficulty placing them in the ventricle in many traumatic cases because of small ventricular size. These factors led us to develop a new system for monitoring ICP which we are describing in this report. Method The screw that we

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Gene H. Barnett, Allan H. Ropper and June Romeo

T he role of intracranial pressure (ICP) monitoring in the therapy and prediction of outcome of many neurological disorders remains uncertain. However, careful monitoring and therapy of elevated ICP in Reye's syndrome in children has been associated with improved survival when used as part of a comprehensive treatment regimen. 2, 4, 6, 7 The relationship between ICP and outcome in adult encephalitis, an illness with high morbidity and mortality rates, has not been systematically studied. To help define the role of raised ICP and ICP monitoring in adult

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James E. Cottrell, Bhagwandas Gupta, Harry Rappaport, Herman Turndorf, Joseph Ransohoff and Eugene S. Flamm

D eliberate hypotension is frequently used in neurosurgical patients to reduce blood loss and to provide a relatively bloodless field to facilitate surgery and decrease operative time. Previously reported pharmacological methods of inducing hypotension are not ideal because of lack of easy controllability, toxic metabolites, 17 increase in intracranial pressure (ICP), 6, 19 and rebound hypertension. 5, 11, 14 Nitroglycerin-induced hypotension has recently become popular because of easy control and lack of toxic metabolites and rebound hypertension

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The effect of nimodipine on intracranial pressure

Volume-pressure studies in a primate model

Mark N. Hadley, Robert F. Spetzler, Mary S. Fifield, William D. Bichard and John A. Hodak

N imodipine , a calcium channel blocker, has been shown to increase cerebral blood flow (CBF), particularly in areas of the brain where the blood-brain barrier has been disrupted. Increased CBF in these regions could potentially lead to deleterious increases of intracranial pressure (ICP), particularly in a patient with extensive swelling from stroke or a mass lesion. For this reason, investigators have cautioned against using calcium antagonists in acute stroke patients. 1, 3, 5 This laboratory investigation was undertaken to define the effects of nimodipine