PubMed Health⌕ Search
Home/Archive/PubMed

PubMed · 3075392

[Decompressive trepanation in therapy refractory brain edema].

W Burkert·H D Paver
View original source ↗Export metadata ↓

Abstract

Already in 1905 and 1908 Harvey Cushing carried out decompression operations for the relieving of pressure in inoperable glious tumours and posttraumatic cerebral oedmas. This surgical method of trephination, which later-on was adopted by many other surgeons, was based on the method of the prevention of an incarceration of the mesencephalon in the tentorial slit by an enlargement of the reserve space in the interior of the crane. In case of a posttraumatic cerebral oedema, besides Heppner's work group practically all other authors operated in pronounced late stages of the incarceration. The results obtained were bad. Heppner worked on the basis of a wider indication, operated earlier, and obtained better results. The intervention should be performed on the basis of continuous preoperative measuring of the cerebral pressure. By means of calculations and modelling we were in a position to demonstrate that on both sides very large trephination areas with the relation of the radius of the trephination area to the radius of the head being 2 to 3 are necessary for achieving a sufficient decrease of the pressure by about 20 to 30 torr.

Explore related subjects

Brain EdemaBrain InjuriesHumansIntracranial PressurePrognosisTrephiningEnglish AbstractJournal ArticleReview

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

W Burkert, H D Paver. 1988. [Decompressive trepanation in therapy refractory brain edema].. https://pubmed.ncbi.nlm.nih.gov/3075392/

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed2007

AZD2171, a pan-VEGF receptor tyrosine kinase inhibitor, normalizes tumor vasculature and alleviates edema in glioblastoma patients.

Using MRI techniques, we show here that normalization of tumor vessels in recurrent glioblastoma patients by daily administration of AZD2171-an oral tyrosine kinase inhibitor of VEGF receptors-has rapid onset, is prolonged but reversible, and has the significant clinical benefit of alleviating edema. Reversal of normalization began by 28 days, though some features persisted for as long as four months. Basic FGF, SDF1alpha, and viable circulating endothelial cells (CECs) increased when tumors escaped treatment, and circulating progenitor cells (CPCs) increased when tumors progressed after drug interruption. Our study provides insight into different mechanisms of action of this class of drugs in recurrent glioblastoma patients and suggests that the timing of combination therapy may be critical for optimizing activity against this tumor.

Brain Edema↗
PubMed2006

Third-trimester fetal MRI in isolated 10- to 12-mm ventriculomegaly: is it worth it?

OBJECTIVE: The justification for magnetic resonance imaging (MRI) in isolated mild ventriculomegaly remains controversial. This study was undertaken to evaluate the contribution of third-trimester MRI in isolated 10- to 12-mm fetal ventriculomegaly. DESIGN: Observational prospective cohort study. SETTING: Universitary prenatal reference centre. POPULATION: From February 2000 to May 2005, we prospectively collected data concerning fetuses referred to us for cerebral MRI following detection of ventriculomegaly by ultrasound scan (n= 310). METHODS: Among these, we identified and analysed those cases in which ventriculomegaly was isolated and did not exceed 12 mm in ultrasound examinations prior to MRI scan (n= 185). MAIN OUTCOME MEASURE: Cases in which MRI provided additional information that was likely to have an impact on prenatal management were detailed. RESULTS: During the study period, 310 MRI were performed because of fetal ventriculomegaly. Hundred and eighty-five were suspected to be isolated 10- to 12-mm ventriculomegalies in ultrasound scan and formed our database. MRI confirmed the 10- to 12-mm isolated fetal ventriculomegaly in 106 cases (57.3%) and found other abnormalities in 5 (4.7%) of these 106 cases. MRI found ventricular measurement to be less than 10 mm in 43 cases (23.3%) and more than 12 mm in 36 cases (19.4%). Among these 36 fetuses with ventricle size more than 12 mm, 6 (16.7%) had other abnormalities, whereas MRI did not find other abnormalities in the 43 cases with ventricle size below 10 mm. CONCLUSION: Before advantages of MRI to ultrasound examination can be demonstrated, it seems reasonable that MRI should remain an investigational tool, restricted to selected clinical situations in which the results are expected to modify case management. Where ultrasound scan suspects isolated ventriculomegaly of 10 to 12 mm, our data suggest that when the finding is confirmed with MRI this could be expected in around 5% of cases. Therefore, the policy of routine MRI in such cases should depend on prenatal centres' priorities.

Brain Edema↗