[Etiology of cerebral perfusion disorder in patients with severe craniocerebral trauma]

In 53 patients with severe head injury, a decline of the cerebral perfusion pressure (CPP) was distinguished related to its cause, i.e., by a rise in intracranial pressure (ICP), a decline in the mean arterial pressure (MAP) or both. The mean Glasgow Outcome Scale (GOS) was 1.6 in patients with elevated ICP, 3.8 in those with decreased MAP and 2.7 when impaired CPP was due to both. It is concluded that in cases of decreased CPP, elevated ICP is the main cause of secondary brain injury and poor outcome, independent of the circulatory condition, whereas an isolated decline in the MAP does not show any influence on functional outcome.