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Oedema Fluid Formation Within Contused Brain Tissue as a Cause of Medically Uncontrollable Elevation of Intracranial Pressure: The Role of Surgical Therapy

  • Y. Katayama
  • T. Tsubokawa
  • S. Miyazaki
  • T. Kawamata
  • A. Yoshino
Part of the Acta Neurochirurgica book series (NEUROCHIRURGICA, volume 51)

Summary

In patients with focal cerebral contusions, medical therapies have generally been advocated unless haemorrhages significantly contributing to the elevated intracranial pressure (ICP) exist. We report here several lines of clinical evidence which indicate that (1) enormous amount of extracellular oedema fluid is formed within contused brain tissue, (2) the formation of extracellular oedema fluid within contused brain tissue alone can be a cause of medically uncontrollable elevation of ICP and (3) surgical excision of the contused brain tissue provides excellent control of the elevated ICP in such patients. The excision of contused brain tissue appears to be the only therapy currently available to alleviate the formation of extracellular oedema fluid in cerebral contusions. We believe that, if ICP is elevated primarily by extracellular oedema due to cerebral contusions and the elevated ICP is medically uncontrollable, surgical excision of contused brain tissue should be carried out without delay regardless of the size of associated haemorrhages.

Keywords

Glasgow Coma Scale Elevated Intracranial Pressure Oedema Fluid Cerebral Contusion Intensive Medical Therapy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag 1990

Authors and Affiliations

  • Y. Katayama
    • 1
  • T. Tsubokawa
    • 1
  • S. Miyazaki
    • 1
  • T. Kawamata
    • 1
  • A. Yoshino
    • 1
  1. 1.Department of Neurological SurgeryNihon University School of MedicineTokyoJapan

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