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Related Concept Videos

Increased Intracranial Pressure l: Introduction01:14

Increased Intracranial Pressure l: Introduction

Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...
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A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
Increased Intracranial Pressure ll: Pathophysiology01:29

Increased Intracranial Pressure ll: Pathophysiology

Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins with...
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Related Experiment Video

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Standardized Hemorrhagic Shock Induction Guided by Cerebral Oximetry and Extended Hemodynamic Monitoring in Pigs
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[Cerebral hemodynamics and major surgery].

D M M Romeo1, P Betta, G Sanges

  • 1U.O. di Neuropsichiatria Infantile, Università degli Studi di Catania, Catania. dmmromeo@hotmail.it

Minerva Pediatrica
|May 24, 2007
PubMed
Summary

Near infrared spectroscopy (NIRS) monitors cerebral oxygenation and hemodynamics in newborns during major surgery. This technique allows real-time evaluation to reduce risks of cerebral hypoxia.

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Area of Science:

  • Medical Devices
  • Biomedical Engineering
  • Neuroscience

Context:

  • Major surgeries in newborns present risks to cerebral oxygenation and hemodynamics.
  • Non-invasive monitoring is crucial for intraoperative management.
  • Near infrared spectroscopy (NIRS) offers a potential solution for real-time assessment.

Purpose:

  • To evaluate cerebral hemodynamics using NIRS during major surgical interventions in neonates.
  • To assess the feasibility of NIRS in monitoring oxygenation and hemoglobin changes.
  • To identify critical intraoperative periods affecting cerebral oxygenation.

Summary:

  • Twenty-five neonates undergoing surgery for conditions like diaphragmatic hernia and esophageal atresia were monitored using NIRS.
  • Tissue Oxygenation Index (TOI), total hemoglobin (tHb), oxygenated hemoglobin (O2Hb), and deoxygenated hemoglobin (HHb) were measured.
  • Significant decreases in O2Hb, tHb, and TOI, with a concurrent increase in HHb, were observed, particularly during abdominal viscera repositioning.

Impact:

  • NIRS provides real-time insights into cerebral hemodynamics during neonatal surgery.
  • Timely identification of altered oxygenation allows for prompt intervention.
  • This monitoring can potentially reduce the risk of intraoperative cerebral hypoxia and improve patient outcomes.