Imaging and Monitoring for Brain Hypothermia Management
The presence of residual hematoma, rebleeding of subdural hematomas on the other side of the brain, complication of acute hydrocephalus, diffuse brain swelling, and brain stem compression are all dangerous conditions. Computed tomography (CT) imaging is recommended as soon as possible after surgery. Further surgery should not be delayed if indications for surgical intervention have been observed. One of the difficulties of surgery is the misdiagnosis of progression of any subdural hematoma on the other side of the brain that was not observed on the preoperative CT scan. Brain swelling after removal of a subdural hematoma suggests the possibility of progression of other thin subdural hematomas, presence of residual subdural hematoma in the nonsurgical field, or rebleeding of a silent hematoma that was not observed on the CT scan because of mechanical compression of the initial subdural hematoma. If residual hematoma is suspected, further surgical craniotomy should be done immediately.
KeywordsBrain Edema Subdural Hematoma Brain Tissue Oxygen Severe Brain Damage Carotid Blood Flow
Unable to display preview. Download preview PDF.
- 9.Hayashi N (1995) Cerebral hypothermia treatment. In: Hayashi N (ed) Cerebral hypothermia treatment. Sogo Igaku, Tokyo, pp 1–105Google Scholar
- 12.Hayashi N, Hirayama T, Utagawa T, Ohata M (1994) Systemic management of cerebral edema based on a new concept in severe head injury patients. Acta Neurochir [Suppl] 60:541–543Google Scholar
- 15.Nilsson OG, Saveland H, Boris-Moller F, Brandt L, Wieloch T (1996) Increased levels of glutamate in patients with subarachnoid haemorrhage as measured by intracerebral microdialysis. Acta Neurochir [Suppl] 67:45–47Google Scholar
- 18.Sahuquillo J, Amoros S, Santos A (2000) Does an increase in cerebral perfusion pressure always mean a better oxygenated brain? A study in head-injured patients. Acta Neurochir [Suppl] 76:457–462Google Scholar
- 19.Sarrafzadeh AS, Kiening KL, Bardt TF, Schneider GH, Unterberg AW, Lanksch WR (1998) Cerebral oxygenation in contusioned vs. nonlesioned brain tissue: monitoring of Pti02 with Licox and Paratrend. Acta Neurochir [Suppl] 71:186–189Google Scholar