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Part of the book series: Acta Neurochirurgica Supplements ((NEUROCHIRURGICA,volume 72))

Abstract

This paper briefly reviews some basic principles of neurosurgical intensive care of patients with aneurysmal subarachnoid hemorrhage. The importance of early identification of secondary insults are underlined. Special attention is paid to the newly introduced method for neurochemical monitoring by means of intracerebral microdialysis. It is concluded that a well functioning neurointensive care unit constitutes an important organisational frame for the detection, prevention and treatment of secondary insults, after aneurysmal subarachnoidal hemorrhage and that improved results can be expected by applying a modern neurointensive care strategy also for patients with aneurysmal subarachnoid hemorrhage.

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References

  1. Beneviste H (1989) Brain microdialysis. J Neurochem 52: 1667–1679

    Article  Google Scholar 

  2. Cesarini K, HÃ¥rdemark HG, Persson L (1999) Improved survival after aneurysmal subarachnoid hemorrhage: review of management during 12-years. J Neurosurg (in press)

    Google Scholar 

  3. Crompton MR (1964) Cerebral infarction following the rupture of cerebral berry aneurysms. Brain 87: 263–285

    Article  Google Scholar 

  4. Crompton MR (1964) The pathogenesis of cerebral infarction following the rupture of cerebral berry aneurysms. Brain 87: 491–451

    Article  PubMed  CAS  Google Scholar 

  5. Enblad P, Persson L (1997) Impact on clinical outcome of secondary brain insults during the neurointensive care of patients with subarachnoid haemorrhage: a pilot study. J Neurol Neurosurg Psychiatry 62: 515–516

    Article  Google Scholar 

  6. Enblad P, Valtysson J, Andersson J, Lilja A, Valind S, Antoni G, Långstrom B, Hillered L, Persson L (1996) Simultaneous intracerebral microdialysis and positron emission tomography in the detection of ischemia in patients with subarachnoid hemorrhage. J Cereb Blood Flow Metab 16: 637–644

    Article  PubMed  CAS  Google Scholar 

  7. Gal G, Enblad P, Ronne-Engström E, Silander HC, Persson L (1997) Behandling av intrakraniella aneurysm med GD coils: preliminära résultat från Uppsala (Swe) Hygiea, p 106, p 275

    Google Scholar 

  8. Ginsberg MD, Busto R (1998) Combating hyperthermia in acute stroke. A significant clinical concern. Stroke 29: 529–534

    Article  PubMed  CAS  Google Scholar 

  9. Grote E, Hassler W (1988) The critical first minutes after subarachnoid hemorrhage. Neurosurgery 22: 654–661

    Article  PubMed  CAS  Google Scholar 

  10. Hillered L, Persson L, Pontén U, Ungerstedt U (1990) Neuro-metabolic monitoring of the ischaemic human brain using mi-crodialysis. Acta Neurochir (Wien) 102: 91–97

    Article  CAS  Google Scholar 

  11. Hårdemark HG, Almqvist O, Johansson T, Påhlman S, Persson L (1989) S-100 Protein in cerebrospinal fluid after aneurysmal subarachnoid haemorrhage: relation to functional outcome, late CT and SPECT changes, and signs of higher cortical dysfunction. Acta Neurochir (Wien) 99: 135–144

    Article  Google Scholar 

  12. Knuckey NW, Fox RA, Surveyor I, Stokes, BAR (1985) Early cerebral blood flow and computerized tomography in predicting ischemia after cerebral aneurysm rupture. J Neurosurg 62: 850–855

    Article  PubMed  CAS  Google Scholar 

  13. Ljunggren B, Fodstad H, von Essen C, Säveland H, Brandt L, Hillman J, Romner B, Elgers G (1988) Aneurysmal subarachnoid haemorrhage: overall outcome and incidence of early recurrent haemorrhage despite a policy of acute stage operation. Br J Neurosurg 2: 49–53

    Article  PubMed  CAS  Google Scholar 

  14. Lundberg N, Kjällquist Å, Bien CH (1959) Reduction of increased intracranial pressure by hyperventilation. Acta Psy-chiatr Scand [Suppl] 34: 139

    Google Scholar 

  15. Lundberg N (1960) Continuous recording and control of ventricular fluid pressure in neurosurgical practice. Acta Psychiat Neurol Scand [Suppl] 36: 149

    Google Scholar 

  16. Löfgren J, Zwetnow NN (1972) Kinetics of arterial and venous haemorrhage in the skull cavity. In: Brock M, Dietz H (eds) Intracranial pressure. Springer, Berlin Heidelberg New York, pp 155–159

    Chapter  Google Scholar 

  17. Nornes H, Magnaes B (1972) Intracranial pressure in patients with ruptured saccular aneurysm. J Neurosurg 36: 537–547

    Article  PubMed  CAS  Google Scholar 

  18. Nornes H (1973) The role of intracranial pressure in the arrest of hemorrhage in patients with ruptured intracranial aneurysm. J Neurosurg 39: 226–234

    Article  PubMed  CAS  Google Scholar 

  19. Persson L, Hillered L (1992) Chemical monitoring of neurosurgical intensive care patients using intracerebral micro-dialysis. J Neurosurg 76: 72–80

    Article  PubMed  CAS  Google Scholar 

  20. Persson L, Hårdemark HG, Edner G, Ronne-Engström E, Mendel-Hartvig I, Påhlman S (1988) S-100 protein in cerebrospinal fluid of patients with subarachnoid haemorrhage: a potential marker of brain damage. Acta Neurochir (Wien) 93: 116–122

    Article  CAS  Google Scholar 

  21. Persson L, Valtysson J, Enblad P, Wärme PE, Cesarmi K, Lewén A, Hillered L (1996) Chemical monitoring using intracerebral microdialysis in patients with subarachnoid hemorrhage. J Neurosurg 84: 606–616

    Article  PubMed  CAS  Google Scholar 

  22. Reilly PL, Graham DI, Adams JH, Jennett B (1975) Patients with head injury who talk and die. Lancet 2: 375–377

    Article  PubMed  CAS  Google Scholar 

  23. Robinson T, Justice JG (1991) Microdialysis in the neurosciences. Elsevier, Amsterdam

    Google Scholar 

  24. Rose J, Valtonen S, Jennett B (1977) Avoidable factors contributing to death after head injury. Br Med J 2: 615–618

    Article  PubMed  CAS  Google Scholar 

  25. Schievink WI, Wijdicks EFM, Parisi JE, Piepgras DG, Whisn-ant JP (1995) Sudden death from aneurysmal subarachnoid hemorrhage. Neurology 45: 871–874

    Article  PubMed  CAS  Google Scholar 

  26. Symon L (1978) Disordered cerebro-vascular physiology in aneurysmal subarachnoid haemorrhage. Acte Neurochir (Wien) 41:7–22

    Article  CAS  Google Scholar 

  27. Såveland H, Nilsson OG, Boris-Möller F, Wieloch T, Brandt L (1996) Intracerebral microdialysis of glutamate and aspartate in two vascular territories after aneurysmal subarachnoid hemorrhage. Neurosurgery 38: 12–20

    Article  PubMed  Google Scholar 

  28. Valtysson J, Jiang M, Persson L (1992) Transient elevation of the intracranial pressure increases the infarct size and perifocal edema after subsequent middle cerebral artery occlusion in the rat. Neurosurgery 30: 887–890

    Article  PubMed  CAS  Google Scholar 

  29. Voldby B, Enevoldsen E, Jensen F (1985) Cerebrovascular reactivity in patients with ruptured intracranial aneurysms. J Neurosurg 62: 59–67

    Article  PubMed  CAS  Google Scholar 

  30. Voldby B, Enevoldsen E, Jensen FT (1985) Regional CBF, intraventricular pressure and cerebral metabolism in patients with ruptured intracranial aneurysms. J Neurosurg 62: 48–58

    Article  PubMed  CAS  Google Scholar 

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© 1999 Springer-Verlag Wien

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Persson, L., Enblad, P. (1999). Neurointensive Care of Aneurysmal SAH. In: Langmoen, I.A., Lundar, T., Aaslid, R., Reulen, HJ. (eds) Neurosurgical Management of Aneurysmal Subarachnoid Haemorrhage. Acta Neurochirurgica Supplements, vol 72. Springer, Vienna. https://doi.org/10.1007/978-3-7091-6377-1_6

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  • DOI: https://doi.org/10.1007/978-3-7091-6377-1_6

  • Publisher Name: Springer, Vienna

  • Print ISBN: 978-3-7091-7309-1

  • Online ISBN: 978-3-7091-6377-1

  • eBook Packages: Springer Book Archive

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