Subdural Intracranial Pressure and Cerebral Haemodynamics During General Anaesthesia for Craniotomy in Patients with Cerebral Aneurysm
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Patients with cerebral aneurisms are frequently presented to the neuroanaesthesiologist, although the number is decreasing due to intravascular coiling. In the intensive care setting a significant correlation between ICP and Hunt & Hess gradation has been described in patients with subarachnoid haemorrhage. The relationship between H&H gradation and perioperative ICP is an important issue because measures to decrease ICP may prevent brain swelling and improve surgical access. It therefore seems reasonable to investigate this issue, taking both patient positioning and anaesthetic technique into consideration. In this chapter two studies are presented. In the first study we investigated the subdural ICP and cerebral perfusion pressure in patients with cerebral aneurysm anaesthetized with either propofol-fentanyl or isoflurane- fentanyl. In the second study the effect of 10 degrees reverse Trendelenburg position on subdural ICP and cerebral perfusion pressure in patients subjected to craniotomy for cerebral aneurysm were investigated.
KeywordsCerebral Blood Flow Intracranial Pressure Cerebral Perfusion Pressure Cerebral Blood Volume Cerebral Aneurysm
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- Algotsson L, Messeter K, Nordström CH et al (1988) Cerebral blood flow and oxygen consumption during isoflurane and halothane anaesthesia in man. Acta Anaestheiol Scand 32:15–20Google Scholar
- Hartmann A (1980) Continuous monitoring of CSF pressure in acute subarachnoid hemorrhage. In: Shulman K, Marmarau A, Miller JD, Becker DP, Hochwald GM, Brock M (eds) Intracranial pressure IV. Springer, Berlin, pp 220–228Google Scholar
- Madsen JB (1991) Changes in CBF and CMRO2 in patients undergoing craniotomy with propofol infusion. In: Prys-Roberts C (ed) Focus on infusion. Current Medical Literature pp 162–164Google Scholar
- Murphy FL, Kennell EM, Johnstone RE et al (1974) The effects of enflurane, isoflurane and halothane on cerebral blood flow and metabolism in man. Abstracts and scientific papers. Annual meeting of the Am Soc Anaesth, pp 61–62Google Scholar
- Petersen KD, Landsfeldt U, Cold GE et al (2003) Intracranial pressure and cerebral hemodynamic in patients with cerebral tumours. A randomized prospective study of patients subjected to craniotomy in propofol-fentanyl, isoflurane-fentanyl, or sevoflurane-fentanyl anesthesia. Anesthesiology 98:329–336PubMedCrossRefGoogle Scholar
- Schneider GH, von Helden GH, Franke R et al (1993) Influence of body position on jugular venous oxygen saturation, intracranial pressure and cerebral perfusion pressure. Acta Neurochir Suppl 59:107–112Google Scholar