Toshifumi Otsuka

The Value of Intracranial Pressure (ICP) Measurement in Acute Severe Head Injury Showing Diffuse Cerebral Swelling

Computerized tomography (CT) is widely used today for the diagnosis and management of patients with severe head injury (1, 2, 4, 8, 9). It has recently been shown that diffuse cerebral swelling can be detected by CT in the early stages of severe acute head injury (1, 4, 8, 9). To our knowledge, there have not been many studies dealing with monitoring of raised intracranial pressure (ICP) caused by diffuse cerebral swelling (1, 4, 9). In this study, we determined the diagnostic value of ICP measurement in patients showing diffuse cerebral swelling.

The Outcome with Barbiturate Therapy in Severe Head Injuries

Barbiturate rapidly lowers intracranial pressure (ICP) and this may prevent potential secondary cerebral ischemic insults. A number of reports have described the use of high dose barbiturate in head injuries with or without assessment of effect on outcome (Saul and Ducker 1982; Marshall et al. 1979; Nordby et al. 1984). In order to define barbiturate effect in severe head injuries, a 3-year comparative study of high dose barbiturate therapy was undertaken (Yano et al. 1985).

Causes and Treatment of Desaturation in SjO2 Monitoring

To minimize secondary brain damage, which greatly influences prognosis during brain damage, it is necessary to avoid the state of ischemia as much as possible because ischemia is an important factor in secondary brain damage. On the other hand, because ischemia has various causes, gaining an understanding of its pathology and deciding on a course of treatment is certainly not easy. In an attempt to resolve this problem, continuous monitoring of jugular bulb venous oxygen saturation (SjO2) has recently attracted considerable attention. SjO2 reflects the status of total brain oxygen metabolism because its value is determined by the ratio between cerebral blood flow and brain oxygen metabolism.

Clinical Analysis of Intracranial Hypertension in Severe Head Injury

It has been emphasized that intensive care is necessary in the management of severe head trauma. Diagnosis and treatment of elevated intracranial pressure (ICP) is especially important. ICP monitoring is useful as an early warning system and for evaluation of therapeutic effects.