Journal of Korean Neurosurgical Society
- Volume 30 Issue 3
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- Pages.295-306
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- 2001
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- 2005-3711(pISSN)
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- 1598-7876(eISSN)
Intracranial Pressure and Cerebral Blood Flow Monitoring after Bilateral Decompressive Craniectomy in Patients with Acute Massive Brain Swelling
급성 중증 뇌종창 환자의 양측성 감압개두술 후 뇌압 및 뇌혈류 측정
- Yoo, Do-Sung (Department of Neurosurgery, Uijongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
- Kim, Dal-Soo (Department of Neurosurgery, Uijongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
- Huh, Pil-Woo (Department of Neurosurgery, Uijongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
- Cho, Kyoung-Suck (Department of Neurosurgery, Uijongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
- Park, Chun-Kun (Department of Neurosurgery, Uijongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
- Kang, Joon-Ki (Department of Neurosurgery, Uijongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine)
- 유도성 (가톨릭대학교 의과대학 의정부성모병원 신경외과학교실) ;
- 김달수 (가톨릭대학교 의과대학 의정부성모병원 신경외과학교실) ;
- 허필우 (가톨릭대학교 의과대학 의정부성모병원 신경외과학교실) ;
- 조경석 (가톨릭대학교 의과대학 의정부성모병원 신경외과학교실) ;
- 박춘근 (가톨릭대학교 의과대학 의정부성모병원 신경외과학교실) ;
- 강준기 (가톨릭대학교 의과대학 의정부성모병원 신경외과학교실)
- Received : 2000.05.29
- Accepted : 2000.08.17
- Published : 2001.03.28
Abstract
Objectives : The management of massive brain swelling remains an unsolved problem in neurosurgical field. Despite newly developed medical and pharmacological therapy, the mortality and morbidity due to massive brain swelling remains high. According to many recent reports, surgical decompression with dura expansion is superior to medical management in patients with massive brain swelling. We performed surgical treatment on the first line of treatment, and followed medical management in case with refractory increased intracranial pressure(ICP). To show the quantitative effect of decompressive surgery on the intracranial pressure, we performed ventricular puncture and checked the ventricular ICP continuously during the decompressive surgery and postoperative period. Materials and Methods : Fifty-one patients with massive brain swelling, undergoing bilateral decompressive craniectomy with dura expansion, were studied in this study. In all patients, ventricular puncture was performed at Kocher's point on the opposite side of massive brain swelling. The ventricular pressure was monitored continuously, during the bilateral decompression procedures and postoperative period. Results : The initial ventricular ICP were varied from 13mmHg to 112mmHg. Immediately after the bilateral craniectomy, mean ventricular ICP decreased to