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Brain Protection by Barbiturate After Head Injury? Clinical and Experimental Results

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Brain Protection

Abstract

Barbiturates have been shown to exhibit a potentially beneficial effect in different models of cerebral ischemia, focal insult, and head trauma with raised intracranial pressure. Although the mechanism of action is not yet fully understood, it seems probable that “protection” is the consequence of the depression of functional metabolism of the nerve cells, thus not comparable to the true protection observed under hypothermia, and it is logical to assume that this unspecific effect may also be observed when using other drugs that equally depress CMRO2 and CBF, such as althesin or etomidate. The subject of this article are clinical and experimental aspects of barbiturates in head trauma, especially their effect on intracranial pressure (ICP) and the development of brain edema.

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References

  1. Arnold H, Laas R (1980) Plateau waves: production in the rat and simulation by means of a mechanical model. In: Shulman K, Marmarou A, Miller JD, Becker DP, Hochwald GM, Brock M. Eds. Intracranial pressure IV. Springer, Berlin Heidelberg New York, pp 525–529 PP

    Chapter  Google Scholar 

  2. Baethmann A, Schmiedek O (1973) Pathophysiology of cerebral edema: Chemical aspects. Advanc Neurosurg 1:5–18

    Google Scholar 

  3. Ciasen RA, Pandolfi S, Casey D Jr (1974) Furosemide and pentobarbital in cryogenic cerebral injury and edema. Neurology 24:642–648

    Google Scholar 

  4. Gaab M (1980) Die Registrierung des intrakraniellen Druckes. Grundlagen, Techniken, Ergebnisse und Möglichkeiten. Thesis for habilitation, Würzburg

    Google Scholar 

  5. Gaab M, Herrmann F, Kerscher J, Rausch K, Lochner J, Pflughaupt KW (1979) Comparison on the effects of dexamethasone, barbiturate and THAM on experimental brain edema. Acta Neurochir 493, Suppl 28, pp 493–497

    Google Scholar 

  6. Hacker H (1982) Dynamic CT in cerebrovascular pathology. In: Cecchini A, Nappi G, Arrigo A. Eds. Neuroradiological and neurophysiological conditions. Emiras, Pavia, pp 223–224

    Google Scholar 

  7. Harbaugh RD, James HE, Marshall LF, Shapiro HM, Laurin R (1979) Acute therapeutic modalities for experimental vasogenic edema. Neurosurgy 5:656–665

    Article  CAS  Google Scholar 

  8. Horsley J (1937) The intracranial pressure during barbital narcosis. Lancet 232:141–143

    Article  Google Scholar 

  9. Kuhl DE, Alavi A, Hoffman EJ, Phelps ME, Zimmerman RA, Obrist WD, Bruce DA, Greenberg JH, Uzzell B (1980) Local cerebral blood volume in head-injured patients. Determination by emission computed tomography of 99mTc-labeled red cells. J Neurosurg 52:309–320

    Article  PubMed  CAS  Google Scholar 

  10. Marshall LF, Shapiro HM (1977) Barbiturate control of intracranial hypertension in head injury and other conditions: iatrogenic coma. Acta Neurol Scand 56, Suppl 64, pp 156–157

    Google Scholar 

  11. Marshall LF, Smith RW, Shapiro HM (1979) The outcome with aggressive treatment in severe head injuries. Part II: Acute and chronic barbiturate administration in the management of head injury. 3 Neurosurg 50:26–30

    Article  CAS  Google Scholar 

  12. Pappius HM, Wolfe LS (1982) Effect of drugs on local cerebral glucose utilization in traumatized brain: mechanism of action of steroids revisited. In: 5th Int Symp Brain Edema, Groningen, Abstr 24, p 44

    Google Scholar 

  13. Rausch A (1982) Barbiturate in der Behandlung des traumatischen Hirnödems. Eine tierexperimentelle Untersuchung. Inaugural dissertation, Würzburg

    Google Scholar 

  14. Reneau DD, Halsey JH (1978) Interpretation of oxygen disappearance rates in brain cortex following total ischaemia. In: Silver IA, Erecińska M, Bicher HI. Eds. Oxygen transport to tissue. Vol III. Plenum Press, New York, pp 189–198

    Google Scholar 

  15. Risberg J, Lundberg N, Ingvar DH (1969) Regional cerebral blood volume during acute transient rises of the intracranial pressure (plateau waves). J Neurosurg 31:303–310

    Article  PubMed  CAS  Google Scholar 

  16. Shapiro HM, Galindo A, Wyte SR, Harris AB (1972) Acute intracranial hypertension during anesthetic induction: partial control with thiopental. Europ Neurol 8:118–121

    Article  PubMed  CAS  Google Scholar 

  17. Shapiro HM, Galindo A, Wyte SR, Harris AB (1973) Rapid intraoperative reduction of intracranial pressure with thiopentone. Brit J Anaesth 45:1057–1062

    Article  PubMed  CAS  Google Scholar 

  18. Smith AL, Marque JJ (1976) Anesthetics and cerebral edema. Anesthesiology 45:64–72

    Article  PubMed  CAS  Google Scholar 

  19. Séndergard W (1961) Intracranial pressure during general anaesthesia. Dan Med Bull 8:18–25

    Google Scholar 

  20. Wodarz R, Gaab M, Pflughaupt KW, Nadjmi M (1980) Measuring regional cerebral blood volume (rCBV) by routine CAT scanning. Methods and results. Inf Advanc Neurosurg. Vol 9. Springer, Berlin Heidelberg New York, pp 374–377

    Google Scholar 

  21. Woringer E, Brogly G, Schneider J (1951) Étude de Paction des anesthésiques généraux usuels sur la pression du liquide céphalo-rachidien; remarques pratiques quant à leur utilisation en chirurgie nerveuse. Anésth Analg (Paris) 8:649–662

    CAS  Google Scholar 

  22. Young W (1980) H2 clearance measurement of blood flow: a review of technique and Polarographie principles. Stroke 11:552–564

    Article  PubMed  CAS  Google Scholar 

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© 1983 Springer-Verlag Berlin Heidelberg

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Sold, M., Gaab, M.R., Poch, B., Heller, V. (1983). Brain Protection by Barbiturate After Head Injury? Clinical and Experimental Results. In: Wiedemann, K., Hoyer, S. (eds) Brain Protection. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-69175-1_17

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  • DOI: https://doi.org/10.1007/978-3-642-69175-1_17

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-69177-5

  • Online ISBN: 978-3-642-69175-1

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