• Journal of Korean Neurosurgical Society
• /
• 제65권1호
• /
• pp.151-160
• /
• 2022

Continuous monitoring of intracranial pressure is a well established medical procedure. Still, little is known about long-term behavior of intracranial pressure in normal pressure hydrocephalus. The present study is designed to evaluate periodicity of intracranial pressure over long-time scales using intraventricular pressure monitoring in patients with normal pressure hydrocephalus. In addition, the circadian and diurnal patterns of blood pressure and body temperature in those patients are studied. Four patients, selected with "probable" normal pressure hydrocephalus, were monitored for several dozen hours. Intracranial pressure, blood pressure, and body temperature were recorded hourly. Autocorrelation functions were calculated and cross-correlation analysis were carried out to study all the time-series data. Autocorrelation results show that intracranial pressure, blood pressure, and body temperature values follow bimodal (positive and negative) curves over a day. The cross-correlation functions demonstrate causal relationships between intracranial pressure, blood pressure, and body temperature. The results show that long-term fluctuations in intracranial pressure exhibit cyclical patterns with periods of about 24 hours. Continuous intracranial pressure recording in "probable" normal pressure hydrocephalus patients reveals circadian fluctuations not related to the day and night cycle. These fluctuations are causally related to changes in blood pressure and body temperature. The present study reveals the complete loss of the diurnal blood pressure and body temperature rhythmicities in patients with "probable" normal pressure hydrocephalus.

• 대한약리학회지
• /
• 제13권2호
• /
• pp.19-34
• /
• 1977

1) 마취가토(痲醉家兎) 및 묘(猫)에서 경뇌막외강(硬腦膜外腔)을 통(通)한 가압방법(加壓方法)으로 두개내압상승(頭蓋內驅上昇)과 혈압(血壓) 및 심박(心搏)과의 관계(關係)를 조사(調査)하였다. 2) 양동물(兩動物)에서 두개내압(頭盞內壓)을 상승(上昇)시켜 두개내압(頭蓋內壓)과 혈압(血壓)의 차(差)가 아주 적어지면 현저(顯著)한 혈압상승(血壓上昇)이 나타났다. 3) 양동물(兩動物)에서 두개내압(頭盞內壓)이 혈압(血壓)보다 높아지면 현저(顯著)한 혈압하강(血壓下降)과 현저(顯著)한 일시적(一時的)인 심박감소(心搏減少)가 나타났다. 4) Reserpine 처리동물(處理動物)에서는 두개내압상승(頭蓋內驅上昇)은 혈압하강(血壓下降), 심박감소(心搏減少)를 일으켰다. 5) 6-Hydroxydopamine 처리(뇌내)동물(處理(腦內)動物)에서는 두개내압상승(頭蓋內驅上昇)에 의한 혈압상승(血壓上昇)은 비처리동물(非處理動物)에 비(比)하여 약(弱)하였다. 6) Reserpine 처리동물(處理動物)의 측뇌실내(側腦室內)에 norepinephrine을 투여(投與)한 후(後)에는 두개내압상승(頭蓋內驅上昇)은 현저(顯著)한 혈압상승(血壓上昇)을 일으켰다. 7) 두개내압상승(頭蓋內驅上昇)에 의한 혈압상승(血壓上昇)은 두개내압상승(頭蓋內驅上昇)으로써 뇌내(腦內) noradrenergic neuron이 자극(刺戟)되여 norepinephrine 유리(遊離)가 증가(增加)한 결과(結果) 일어나는 것으로 추리(推理)하였다.

• Journal of Korean Neurosurgical Society
• /
• 제47권1호
• /
• pp.7-10
• /
• 2010

Objective: In this study, we present a simple closed head injury model as a two-stage experiment. The height of the weight drop enables gradation of head trauma severity. Methods: The head injury device consists of three parts and there are three adjustable parameters-weight (100-600 g). height of fall (5-100 cm) and elasticity of the springs. Thirty male Wistar rats underwent monitoring of intracranial pressure with and without induction of the head injury. Results: The weight drop from 45 to 100 cm led to immediate seizure activity and early death of the experimental animals. Severe head injury was induced from 40 cm weight drop. There was 50% mortality and all surviving rats had behavioral deterioration. Intracranial pressure was 9.3${\pm}$3.76 mmHg. Moderate head injury was induced from 35 cm, mortality decreased to 20-40%, only half of the animals showed behavioral pathology and intracranial pressure was 7.6${\pm}$3.54 mmHg. Weight drop from 30 cm caused mild head injury without mortality and neurological deterioration. Intracranial pressure was slightly higher compared to sham group- 5.5${\pm}$0.74 mmHg and 2.9${\pm}$0.81 mmHg respectively. Conclusion: This model is an eligible tool to create graded brain injury with stepwise intracranial pressure elevation.

• 대한한방내과학회지
• /
• 제15권1호
• /
• pp.80-98
• /
• 1994

According to the original documents, Sagungsan is considered as an effective drug for controlling the hypertensive epistaxis induced by tension of autonomic nerve and it's hyperfunction. The present experiment was designed to understand the effect of Sagungsan extract on the hemostatic action, intracranial pressure, blood pressure and cardiovascular system in experimental animals. And thus the bleeding time, prothrombin time, capillary dilation, blood pressure, Intracranial pressure, and enzymatic analysis of the ATPase activities were studied. The result obtained here were as followings: 1. Sagungsan water extract reduced the bleeding time in mouse, and prolonged the prothrombin time in rabbits. 2. The drug extract increased the tail volume by capillary dilation in rats. 3. The drug extract inhibited the increase of intracranial pressure and arterial blood pressure in rabbits. 4. At the early time, the increase of arterial blood pressure by the drug extract significantly inhibited by pretreated atropin and regitine in rabbits. 5. The drug extract relaxed the smooth muscle by stimulating the Mg2+-Ca2+-ATPase activities of gastric sarcoplasmic reticulum isolated from rabbit stomach. 6. The drug extract stimulated the heart contraction by inhibiting the $Mg^{2+}-Ca^{2+}-ATPase$ activities of cardiac sarcoplasmic reticulum isolated from rabbit heart. The inhibitory mechanism was reversible and noncompatitive. 7. The drug extract increased the hepatic blood volume by stimulating the hepatic total ATPase activities and hepatic metabolism. 8. The drug extract acted as a tranquilizer by inhibiting the neural Na+-K+-ATPase activity. According to the results, Sagungsan water extract dilated the capillaries, stimulated the heart beat, and thus increased the blood flow with decreasing the intracranial pressure and blood pressure. These effects stanches the epistaxis collectively.

• The Korean Journal of Pain
• /
• 제10권1호
• /
• pp.104-108
• /
• 1997

Spontaneous intracranial hypotension, a syndrome of low CSF pressure, occurs without preceding events such as lumbar puncture, back trauma, operative procedure or medical illness. The most characteristic symptom is an occipital or frontal headache which is aggrevated in the erect position and relieved in the supine position. This syndrome usually resolves spontaneously or with strict bed rest. When the headach persists or is incapacitating, more aggressive treatment may be necessary. Autologous epidural blood patch is highly effective in the management of spontaneous intracranial hypotension. Epidural blood produces an organized clot which effectively tamponade any dural CSF leak. The rapid relief of headache immediately after the infusion of blood occur by some other mechanism, such as an increase in subarachnoid pressure that is known to occur with infusion of fluid into the lumbar epidural space. We report three cases of spontaneous intracranial hypotension successfully treated with epidural blood patch.

• Journal of Korean Neurosurgical Society
• /
• 제30권4호
• /
• pp.425-429
• /
• 2001

Objective : Patients with poor grade aneurysm usually present with increased intracranial pressure(ICP), even those without an intracranial clot. Based on this fact, the present study investigated a significance of intracranial pressure monitoring in those patients. Patients and Methods : A total of 60 patients with Hunt and Hess Grade IV(50 patients) or V(10 patients) were treated for aneurysmal subarachnoid hemorrhage(SAH) during a 3-year-period, and intraparenchymal ICP was measured in the majority, immediately after arrival to the emergency room. Early surgery including intraoperative ventriculostomy was undertaken within 3 days after SAH. An ultraearly surgery was performed without preceding angiogram or ICP monitoring in patients with large sylvian hematomas, highly suggestive of middle cerebral artery aneurysm. Outcomes were assessed by the Glasgow Outcome Scale(GOS) at 6 months. Results : In overall, favorable outcome(GOS scores 1-2) was seen in 27(54.0%) of admission Grade IV and 1(10.0%) of admission Grade V patients. Of the 38 surgical patients with preoperative ICP monitorings, 25 patients (80.6%) exhibiting ICP values of less than 40mmHg showed favorable outcome, however, no patients with ICP values above 40mmHg recovered(Fisher's exact test, p=0.0001). Conclusion : It is concluded that a preoperative ICP above 40mmHg before ventriculostomy indicate significant vital brain destruction as intractable intracranial hypertension, and Grade IV patients at admission with an ICP below 40mmHg can be of benefit from early surgical intervention while Grade V patients still remains unfavorable.

• Archives of Plastic Surgery
• /
• 제32권1호
• /
• pp.29-36
• /
• 2005

Craniosynostosis is the premature fusion of one or more sutures of either cranial vault or base. Fused sutures may impede normal growth of the calvaria, leading to characteristic skull deformities; Morphological craniosynostosis is classified descriptively. Being craniosynostosis uncorrected the deformity progresses continuously and causes an increase of intracranial pressure. The surgical involvement aims at the expansion of intracranial space as well as satisfactory achievement of craniofacial shape. Early surgical correction in infancy prevents the deformity from the further progression and possible associated complication of high intracranial pressure. A long period of follow-up is essential to asses the outcome of an effectiveness of the surgery. measurement of intracranial volume has been concerned in medical personnel and anthropologists for many years. A reliable and accurate measurements of the intracranial volume facilitates to make a diagnosis and treatment of craniosynostosis. Pre-and postoperative change of intracranial volume was evaluated with 3D CT scanning in 12 cases of craniosynostosis who underwent frontal advancement and total cranial vault remodeling. Increased intracranial volume is attributed to surgical release of craniosynostosis and natural growth. We conceive that the intracranial volume is significantly increased after surgical correction of fused cranial sutures and along with natural growing. A procedure of frontal advancement and total cranial vault remodeling is very useful to correct such a deformity as craniosynostosis. And also 2 cases out of five mentally retarded patients improved remarkably and Forehead retrusion or temporal depression followed in another two cases.

• Journal of Yeungnam Medical Science
• /
• 제2권1호
• /
• pp.45-51
• /
• 1985

전신마취시 후두경의 사용과 기관내삽관이 혈압 및 뇌압을 상승시킬 수 있음은 잘 알려져 있으며 이는 이미 뇌압이 상승되어 있는 환자에게는 매우 위험할 수 있다. 따라서 저자들은 현재 통상 시행되고 있는 전신마취 유도방법인 thiopental, S.C.C., intubation 과정이 어느 정도의 뇌압상승을 유발시키는지를 알아보기 위하여, 뇌압측정장치가 되어있는 개두술 환자 13명에게 위와 같은 마취유도시 뇌압 및 동맥압의 변화를 측정하여 보았던바 뇌압은 $7.1{\pm}7.23mmHg$, 동맥압은 $43.5{\pm}25.46nmHg$, 뇌관류압은 $33.3{\pm}27.53mmHg$ 상승되었다. 이러한 결과로 미루어 보아, 이미 뇌압이 상승되어 있는 환자의 마취유도 시에는 필히 마취유도에 따른 뇌압상승을 예방할 수 있는 처치를 강구해야만 할 것으로 사료된다.

• The Korean Journal of Pain
• /
• 제12권1호
• /
• pp.157-161
• /
• 1999

We report a patient with spontaneous intracranial hypotension. In addition to the cardinal feature of a postural headache and a low CSF pressure, the patient also had subdural hematoma demonstrated by brain MRI. Radionuclide cisternography revealed a CSF leakage in the intracranium. CSF leakage from spinal meningeal defects may be the most common cause of this syndrome. The headache is a consequence of the low CSF pressure producing displacement of pain-sensitive structures. Methods of treatment are identical to those for post-dural puncture headaches. We experienced a patient with spontaneous intracranial hypotension developed in the intracranium who was successfully managed with a cervical blood patch.

• The Korean Journal of Pain
• /
• 제13권1호
• /
• pp.130-133
• /
• 2000

Epiduroscopy is a new imaging and invasive technique that has become increasingly popular in the diagnosis and therapy of spinal pain syndrome. However, the risk of epiduroscopy is a major concern due to its invasiveness. The complications include hematoma, infection, neural damage, cardiac failure and raising of intracranial pressure. We have experienced a case of severe diffuse headache and dizziness following 1 day after epiduroscopy. Emergent brain MRI finding has no remarkable sign. The patient was admitted for 5 days to be treated with bed rest, adequate hydration and pain control with analgesics. After the treatments, she was recovered without residual sequelae and discharged. We need to take greater care of the undesirable effects detected intra- and post epiduroscopy, especially sign of increased intracranial pressure. Therefore, close monitoring of intracranial pressure is necessary during epiduroscopy.