PMID- 7617183
OWN - NLM
STAT- MEDLINE
DCOM- 19950824
LR  - 20230808
IS  - 0028-3878 (Print)
IS  - 0028-3878 (Linking)
VI  - 45
IP  - 7
DP  - 1995 Jul
TI  - Large hemispheric infarction, deterioration, and intracranial pressure.
PG  - 1286-90
AB  - Neurologic deterioration from large hemispheric infarction with edema (LHIE) 
      often leads to the use of therapies directed at decreasing intracranial pressure 
      (ICP). Many of these ICP therapies can potentially accentuate tissue shifts from 
      unilateral mass lesions and lead to rebound ICP elevations. We sought to 
      determine whether ICP elevation is a common cause of deterioration from LHIE by 
      measuring the initial ICP and cerebral perfusion pressure (CPP) in 19 patients 
      deteriorating to stupor from LHIE within 3 hours of deterioration, after ruling 
      out metabolic aberrations, medication side effects, infection, and seizures and 
      prior to commencement of any ICP-lowering therapies. We evaluated 19 patients 
      aged 23 to 77 years--14 with complete middle cerebral artery and five with 
      complete internal carotid artery territory infarctions. Stupor began 59 +/- 37 
      hours after the stroke onset. ICP monitoring (12 ipsilateral Camino, five 
      contralateral ventriculostomy, and two ipsilateral epidural) demonstrated 
      elevation of ICP (> 15 mm Hg) in only five patients (26.3%), with group mean 
      initial ICP = 13.4 +/- 10 mm Hg. Similarly, the initial CPP was diminished (< 55 
      mm Hg) in only two patients (10.5%), with group mean initial CPP = 74.9 +/- 14 mm 
      Hg. Globally elevated ICP is not a common cause of initial neurologic 
      deterioration from LHIE mass effect.
FAU - Frank, J I
AU  - Frank JI
AD  - Department of Neurosurgery, Cleveland Clinic Foundation, OH 44195, USA.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Neurology
JT  - Neurology
JID - 0401060
SB  - IM
CIN - Neurology. 1996 Apr;46(4):1186. PMID: 8780127
MH  - Adult
MH  - Aged
MH  - Brain Edema/etiology/*physiopathology
MH  - Cerebral Infarction/complications/*physiopathology
MH  - Female
MH  - Humans
MH  - *Intracranial Pressure
MH  - Male
MH  - Middle Aged
MH  - Monitoring, Physiologic
EDAT- 1995/07/01 00:00
MHDA- 1995/07/01 00:01
CRDT- 1995/07/01 00:00
PHST- 1995/07/01 00:00 [pubmed]
PHST- 1995/07/01 00:01 [medline]
PHST- 1995/07/01 00:00 [entrez]
AID - 10.1212/wnl.45.7.1286 [doi]
PST - ppublish
SO  - Neurology. 1995 Jul;45(7):1286-90. doi: 10.1212/wnl.45.7.1286.