Massive Intraoperative Brain Swelling — Can It Be Treated?

  • L. F. Marshall
  • U. Song Hoi

Abstract

In the past, massive intraoperative brain swelling has usually been associated with a fatal outcome. This report describes the use of large doses of thiobarbiturate as a means of treating massive intraoperative brain swelling. The results of the initial eleven cases, (five arteriovenous malformations, four hematomas, and two penetrating injuries), are as follows: six patients made a good recovery, one is moderately disabled, one is severely disabled, and two are dead. These data suggest that this condition, which once was considered unmanageable, can indeed be managed and that treatment often results in an acceptable outcome. Furthermore, more recent experience suggests that the use of planned, deep thiobarbiturate anesthesia, with induced electrocerebral silence during intracranial operations, may even prevent the occurrence of this phenomenon.

Keywords

Catheter Neurol Nial Thiobarbiturate Barbiturate 

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References

  1. Albin, M.S., Benegin, L., Dujovny, M., Bennett, M., Jannetta, P. and Wistozkey, H.: Brain retraction pressure during intracranial procedures. Surgical Forum 26:499, 1975PubMedGoogle Scholar
  2. Langfitt, T.W., Weinstein, J.D., and Kassell, N.F.: Vascular factors in head injury: Contribution to brain swelling and intracranial hypertension. In Caveness, W.F., and Walker, A.E., eds.: Head Injury: Conference Proceedings. Philadelphia, J.B. Lippincott Co., 1966. pp. 179–194Google Scholar
  3. Marshall, L.F., Smith, R.W., and Shapiro, H.M.: Outcome with aggressive Treatment in Severe Head Injuries. Acute and Chronic Barbiturate Administration, Part II. J. Neurosurg. 50:26–30, 1979PubMedCrossRefGoogle Scholar
  4. Rockoff, M.A., Marshall, L.F., Shapiro, H.M.: High-dose barbiturate therapy in humans: A clinical review of 60 patients. Ann Neurol 6:194–199, 1979PubMedCrossRefGoogle Scholar
  5. Shapiro, H.M., Galindo, A., Wyte, S.R. and others: Rapid intraoperative reduction of intracranial pressure with thiopentone, Br. J. Anaesth. 45:1057, 1973PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin · Heidelberg 1983

Authors and Affiliations

  • L. F. Marshall
    • 1
  • U. Song Hoi
    • 1
  1. 1.Division of Neurological SurgeryUniversity HospitalSan DiegoUSA

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