Subdural Intracranial Pressure and Degree of Swelling After Opening of Dura in Patients with Supratentorial Tumours
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During craniotomy for a mass-expanding cerebral process such as tumour or haematoma, opening of dura mater represents a critical moment. Cerebral swelling through the craniotomy can seriously jeopardize surgical access and increase the risk of cerebral ischaemia with possible worsening of the outcome. Traditionally, preoperative CT data together with the neurological examination and level of consciousness are used to assess the risk of high ICP. As a consequence, the neurosurgeon together with the anaesthesiologist may decide whether ICP-reducing therapy is indicated before opening of the dura and exposing of the brain. In this chapter two studies of the relationship between subdural ICP and the degree of cerebral swelling after opening of dura mater are presented. The first study examined the relationship between subdural ICP before opening of the dura mater and the dural tension and degree of brain swelling in patients undergoing craniotomy for cerebral tumours or subarachnoid haemorrhage. In the second study we further investigated the relationship between subdural ICP and the degree of brain swelling in a larger population of patients.
KeywordsSubarachnoid Haemorrhage Dura Mater Midline Shift Cerebral Tumour Supratentorial Tumour
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