التفاصيل البيبلوغرافية
| العنوان: |
Characterization of cerebrovascular reactivity after craniectomy for acute brain injury. |
| المؤلفون: |
Wang, E. C., Ang, B. T., Wong, J., Lim, J., Ng, I. |
| المصدر: |
British Journal of Neurosurgery; Feb2006, Vol. 20 Issue 1, p24-30, 7p, 1 Chart, 3 Graphs |
| مصطلحات موضوعية: |
BRAIN injuries, INTRACRANIAL pressure, BRAIN diseases, BLOOD pressure, CEREBROVASCULAR disease |
| مستخلص: |
Analysis of slow waves in arterial blood pressure (ABP) and intracranial pressure (ICP) has been used as an index to describe cerebrovascular pressure-reactivity. It has been previously demonstrated that the pressure-reactivity index (PRx) can be used to reflect global cerebrovascular reactivity with changes in ABP. A positive PRx signifies a positive association between ABP and ICP, indicating a non-reactive vascular bed, while a negative PRx is reflective of intact cerebral autoregulation, where ABP waves provoke inversely correlated waves in ICP. To date, there has been no characterization of pressure-reactivity following decompressive craniectomy. In this prospective observational study, 33 patients who underwent surgery for acute brain injury with mass lesions for which the bone flap was left out were studied. The PRx was calculated as a moving correlation coefficient between 30 consecutive samples of values of ICP and ABP averaged for a period of 10 s. The time profiles of mean PRx values at 6-hourly intervals were analysed and compared with that in seven patients treated by medical therapy alone. The initial mean PRx 6 h after surgery was positive, indicative of disturbed pressure-reactivity. With time, PRx trended towards a more negative value, suggestive of an improving cerebrovascular autoregulatory reserve. The mean PRx 24 h after surgery was 0.28 (±0.26), while the mean PRx 72 h after surgery was 0.15 (±0.25) ( p = 0.012). In contrast, the mean PRx in patients that were not decompressed did not change significantly with time ( p = 0.357). Surgery in acute brain injury for which the bone flap is left out in anticipation of raised intracranial pressure in the postoperative period leads to an improved PRx as compared with controls. Craniectomy in this situation may have a contribution to the restoration of disturbed cerebrovascular pressure-reactivity. [ABSTRACT FROM AUTHOR] |
|
Copyright of British Journal of Neurosurgery is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| قاعدة البيانات: |
Complementary Index |
PDF full text from Publisher