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Статті в журналах з теми "Intracerebral monitoring"

Автор: Grafiati

Опубліковано: 11 січня 2025

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1

Lee, Kevin R., Ivo Drury, Elizabeth Vitarbo, and Julian T. Hoff. "Seizures induced by intracerebral injection of thrombin: a model of intracerebral hemorrhage." Journal of Neurosurgery 87, no. 1 (July 1997): 73–78. http://dx.doi.org/10.3171/jns.1997.87.1.0073.

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✓ The coagulation cascade plays an important role in brain edema formation caused by intracerebral blood. In particular, thrombin produces brain injury via direct brain cell toxicity. Seizures and increased cerebral electrical activity are commonly associated with intracerebral blood and are possible effects of thrombin leading to cell injury in the brain. In this study, artificial clots containing concentrations of thrombin found in hematomas were infused intracerebrally in rats. The animals were observed clinically for seizure activity, behavior, and neurological deficits. Several animals underwent video electroencephalographic (EEG) monitoring during intracerebral infusion and for 30 minutes postinfusion. All animals were killed 24 hours after injection, and brain water and ion contents were measured to determine the amount of brain edema. Clinically, thrombin produced focal motor seizures in all animals. None of the control animals or those receiving Nα-(2-Naphthalenesulfonyl-glycyl)-4-amidino-DL-phenylalanine-piperidide (α-NAPAP), a thrombin inhibitor added to the thrombin, showed clinical evidence of seizures. Of the rats undergoing EEG monitoring, all animals receiving thrombin showed electrical evidence of seizure activity, whereas none of the control animals exhibited seizure activity. There was no evidence of seizure activity on EEG monitoring when α-NAPAP was injected along with the thrombin. In addition, the artificial clots containing thrombin produced agitation and a circling tendency in the rats, along with brain edema. These results indicate that the coagulation cascade is involved in seizure production and increased brain electrical activity, which contribute to the neurological deficits and brain edema formation that are seen with intracerebral hemorrhage.

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2

Hemphill, J. Claude, Diane Morabito, Mary Farrant, and Geoffrey T. Manley. "Brain Tissue Oxygen Monitoring in Intracerebral Hemorrhage." Neurocritical Care 3, no. 3 (2005): 260–70. http://dx.doi.org/10.1385/ncc:3:3:260.

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3

Demierre, Bertrand, Falko A. Stichnoth, Akira Hori, and Otto Spoerri. "Intracerebral ganglioglioma." Journal of Neurosurgery 65, no. 2 (August 1986): 177–82. http://dx.doi.org/10.3171/jns.1986.65.2.0177.

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✓ Ganglioglioma in the temporal lobe was encountered in 0.6% of a series of 998 patients undergoing biopsy for intracranial tumors. It was more frequent in young adults and children. Seizures were the main symptom and had been present over a long period of time in some patients. Clinical examination also revealed intracranial pressure, focal signs, and behavioral problems, but these symptoms were not always evident. Electroencephalography was not specific. Calcifications were visible on computerized tomography (CT) in five cases. The cystic and well-circumscribed aspects of these tumors were apparent on CT scans; these features were confirmed at operation and on magnetic resonance imaging (MRI), when it was also found that the tumors were partially solid. Therefore, MRI seems to be a useful diagnostic method, particularly when a cystic tumor is revealed on CT, and is also valuable for postoperative monitoring. Surgical treatment for ganglioglioma is recommended, with total extirpation if possible.

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4

Santamarina Pérez, Estevo, Raquel Delgado-Mederos, Marta Rubiera, Pilar Delgado, Marc Ribó, Olga Maisterra, Gema Ortega, José Álvarez-Sabin, and Carlos A. Molina. "Transcranial Duplex Sonography for Monitoring Hyperacute Intracerebral Hemorrhage." Stroke 40, no. 3 (March 2009): 987–90. http://dx.doi.org/10.1161/strokeaha.108.524249.

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5

Kapinos, G., and J. C. Hemphill. "Clinicoradiologic acute monitoring after intracerebral hemorrhage: Toward standards?" Neurology 81, no. 2 (June 5, 2013): 102–3. http://dx.doi.org/10.1212/wnl.0b013e31829a3564.

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6

Mathru, M. "Transcranial Duplex Sonography for Monitoring Hyperacute Intracerebral Hemorrhage." Yearbook of Anesthesiology and Pain Management 2010 (January 2010): 171–73. http://dx.doi.org/10.1016/s1073-5437(09)79362-3.

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7

Verlooy, J., L. Heytens, G. Veeckmans, and P. Selosse. "Intracerebral temperature monitoring in severely head injured patients." Acta Neurochirurgica 134, no. 1-2 (March 1995): 76–78. http://dx.doi.org/10.1007/bf01428508.

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8

Helbok, Raimund, Ravi Chandra Madineni, Michael J. Schmidt, Pedro Kurtz, Luis Fernandez, Sang-Bae Ko, Alex Choi, et al. "Intracerebral Monitoring of Silent Infarcts After Subarachnoid Hemorrhage." Neurocritical Care 14, no. 2 (December 2, 2010): 162–67. http://dx.doi.org/10.1007/s12028-010-9472-9.

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9

Bauer, Richard, Michael Gabl, Alois Obwegeser, Klaus Galiano, Josef Barbach, and Iradj Mohsenipour. "Neurochemical monitoring using intracerebral microdialysis during cardiac resuscitation." Intensive Care Medicine 30, no. 1 (January 2004): 159–61. http://dx.doi.org/10.1007/s00134-003-2015-5.

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10

Meybohm, P., E. Cavus, B. Bein, M. Steinfath, B. Weber, J. Scholz, and V. Doerges. "Neurochemical monitoring using intracerebral microdialysis during systemic haemorrhage." Acta Neurochirurgica 149, no. 7 (July 2007): 691–98. http://dx.doi.org/10.1007/s00701-007-1231-0.

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11

Wijono, Andre Dharmawan, and Ida Ayu Sri Indrayani. "Atrial Fibrillation After Spontaneous Intracerebral Hemorrhage." International Journal of Research and Review 11, no. 3 (March 20, 2024): 186–90. http://dx.doi.org/10.52403/ijrr.20240325.

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Introduction: Cardiac arrhythmias often occur during the acute phase of a stroke and can cause hemodynamic instability and sudden cardiac death. Data regarding determinants and the course of arrhythmia onset in the acute phase of stroke are still rare, especially in hemorrhagic stroke. Case report: A male, 74 years old, came to the emergency department with a complaint of weakness in the left hand and leg that had occurred suddenly 5 hours previously. Weakness is described by the left arm and leg still being able to be lifted a few seconds later and falling again. This complaint was accompanied by lips that appear pursed and severe dysarthria. The patient was said to have had a history of uncontrolled hypertension for 10 years. A previous history of heart disease was denied. A CT scan of the head without contrast showed intracerebral hemorrhage in the basal ganglia and right external capsule with a volume of 5 cc. An electrocardiography (ECG) examination showed sinus rhythm without any indication of heart rhythm disturbances. Further ECG examination after the 4th day of hospitalization showed atrial fibrillation with rapid ventricular response (AFRVR). The patient eventually died one day after the heart rhythm changed. Discussion: The incidence of AF varies depending on the type of stroke that occurred, the monitoring device used, the interval between initial monitoring and stroke onset, and the duration of cardiac monitoring. AF in patients can occur as a result of a hemorrhagic stroke, but it is also possible because of the presence of previously undetected paroxysmal AF. High NIHSS correlates with system disturbances in autonomous cardiovascular systems. According to current NIHSS measurements, hospital admission is required as a parameter for heart rhythm monitoring for more than 24 hours. Conclusion: Newly detected AF after ICH greatly influences the clinical outcome of patients. Understanding the mechanism and pathophysiology of new AF after ICH will contribute to a better understanding of the management of the patient. Keywords: atrial fibrillation, cardiac arrhythmia, case report, stroke, intracerebral hemorrhage

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12

Chen, Ching-Jen, Dale Ding, Natasha Ironside, Thomas J. Buell, Andrew M. Southerland, Fernando D. Testai, Daniel Woo, Bradford B. Worrall, and _. _. "Intracranial pressure monitoring in patients with spontaneous intracerebral hemorrhage." Journal of Neurosurgery 132, no. 6 (June 2020): 1854–64. http://dx.doi.org/10.3171/2019.3.jns19545.

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OBJECTIVEThe utility of ICP monitoring and its benefit with respect to outcomes after ICH is unknown. The aim of this study was to compare intracerebral hemorrhage (ICH) outcomes in patients who underwent intracranial pressure (ICP) monitoring to those who were managed by care-guided imaging and/or clinical examination alone.METHODSThis was a retrospective analysis of data from the Ethnic/Racial variations of Intracerebral Hemorrhage (ERICH) study between 2010 and 2015. ICH patients who underwent ICP monitoring were propensity-score matched, in a 1:1 ratio, to those who did not undergo ICP monitoring. The primary outcome was 90-day mortality. Secondary outcomes were in-hospital mortality, hyperosmolar therapy use, ICH evacuation, length of hospital stay, and 90-day modified Rankin Scale (mRS) score, excellent outcome (mRS score 0–1), good outcome (mRS score 0–2), Barthel Index, and health-related quality of life (HRQoL; measured by EQ-5D and EQ-5D visual analog scale [VAS] scores). A secondary analysis for patients without intraventricular hemorrhage was performed.RESULTSThe ICP and no ICP monitoring cohorts comprised 566 and 2434 patients, respectively. The matched cohorts comprised 420 patients each. The 90-day and in-hospital mortality rates were similar between the matched cohorts. Shift analysis of 90-day mRS favored no ICP monitoring (p < 0.001). The rates of excellent (p < 0.001) and good (p < 0.001) outcome, Barthel Index (p < 0.001), EQ-5D score (p = 0.026), and EQ-5D VAS score (p = 0.004) at 90 days were lower in the matched ICP monitoring cohort. Rates of mannitol use (p < 0.001), hypertonic saline use (p < 0.001), ICH evacuation (p < 0.001), and infection (p = 0.001) were higher, and length of hospital stay (p < 0.001) was longer in the matched ICP monitoring cohort. In the secondary analysis, the matched cohorts comprised 111 patients each. ICP monitoring had a lower rate of 90-day mortality (p = 0.041). Shift analysis of 90-day mRS, Barthel Index, and HRQoL metrics were comparable between the matched cohorts.CONCLUSIONSThe findings of this study do not support the routine utilization of ICP monitoring in patients with ICH.

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13

Francis, Richard, Barbara A. Gregson, and A. David Mendelow. "Attitudes to intracranial pressure monitoring of traumatic intracerebral haemorrhage." British Journal of Neurosurgery 28, no. 5 (January 30, 2014): 663–65. http://dx.doi.org/10.3109/02688697.2014.881463.

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14

Nordström, Carl-Henrik. "Insulin, intracerebral glucose and bedside biochemical monitoring utilizing microdialysis." Critical Care 12, no. 2 (2008): 124. http://dx.doi.org/10.1186/cc6826.

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15

lribe, Yuji, Xadashi Kohno, Satoshi Asai, and Koichi Ishikawa. "Real time monitoring of intracerebral glutamate-using “dialysis electrode”." Japanese Journal of Pharmacology 67 (1995): 303. http://dx.doi.org/10.1016/s0021-5198(19)47178-3.

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16

Övü, I., R. S. Madirzade, K. Öner, and S. M. Nadirzade. "A method for monitoring intracerebral temperature in neurosurgical patients." Clinical Neurology and Neurosurgery 99 (July 1997): S151. http://dx.doi.org/10.1016/s0303-8467(97)81960-9.

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17

Mellergård, Pekka, Carl-Henrik Nordström, and Mats Christensson. "A Method for Monitoring Intracerebral Temperature in Neurosurgical Patients." Neurosurgery 27, no. 4 (October 1, 1990): 654–57. http://dx.doi.org/10.1227/00006123-199010000-00029.

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Abstract Current interest in brain temperature and selective brain cooling makes a method allowing for continuous monitoring of intracerebral temperature in humans desirable. The authors describe a safe, simple, and reliable technique using a thermocouple of copper and constantan in combination with intraventricular monitoring of intracranial pressure for measurement of brain temperature in neurosurgical patients.

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18

Ferraro, Thomas N., Peter Weyers, David P. Carrozza, and Wolfgang H. Vogel. "Continuous monitoring of brain ethanol levels by intracerebral microdialysis." Alcohol 7, no. 2 (March 1990): 129–32. http://dx.doi.org/10.1016/0741-8329(90)90073-l.

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19

Bobo, Hunt, Jimmy D. Miller, Owen B. Evans, and John P. Kapp. "Delayed intracerebral hematoma at the site of a subarachnoid bolt pressure monitor." Journal of Neurosurgery 64, no. 4 (April 1986): 673–75. http://dx.doi.org/10.3171/jns.1986.64.4.0673.

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20

Persson, Lennart, and Lars Hillered. "Chemical monitoring of neurosurgical intensive care patients using intracerebral microdialysis." Journal of Neurosurgery 76, no. 1 (January 1992): 72–80. http://dx.doi.org/10.3171/jns.1992.76.1.0072.

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✓ The authors have used intracerebral microdialysis to develop a method for routine monitoring of disturbances in brain energy metabolism in patients in the neurosurgical intensive care unit. Microdialysis was conducted for periods ranging from 2.3 to 8.3 days in four patients (three with severe head injuries and one with severe subarachnoid hemorrhage). Altogether, 4447 chemical analyses from 587 dialysis samples were carried out. Concentrations of the energy-related metabolites lactate, pyruvate, and hypoxanthine were measured, and the lactate:pyruvate ratio was calculated. In addition, the amino acids glutamate, aspartate, taurine, glutamine, asparagine, and glycine were measured in one patient. The microdialysis data were matched with various clinical events, including intracranial hypertension and therapeutic interventions such as initiation or withdrawal of barbiturates and cerebrospinal fluid drainage. The present study shows that microdialysis can be used for long-term measurement of extracellular fluid (ECF) energy-related metabolites and amino acids in the frontal cortex of neurosurgical patients in a clinical setting. Fluctuations of the measured ECF energy-related substances corresponded to various clinical events presumably involving hypoxia/ischemia. The authors found a 25-fold increase in ECF glutamate, aspartate, and taurine under conditions of energy perturbation, as indicated by high levels of the lactate:pyruvate ratio, lactate, and hypoxanthine. The use of long-term intracerebral microdialysis in patients opens a new field of clinical research, with many possibilities for improving insight into intracranial dynamics in acute cerebral conditions.

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21

Persson, Lennart, Johann Valtysson, Per Enblad, Per-Erik Wärme, Kristina Cesarini, Anders Lewén, and Lars Hillered. "Neurochemical monitoring using intracerebral microdialysis in patients with subarachnoid hemorrhage." Journal of Neurosurgery 84, no. 4 (April 1996): 606–16. http://dx.doi.org/10.3171/jns.1996.84.4.0606.

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✓ The authors have developed a method for routine monitoring of disturbances in brain energy metabolism and extracellular levels of excitatory amino acids using intracerebral microdialysis in 10 patients with subarachnoid hemorrhage. Microdialysis was conducted for periods ranging from 6 to 11 days after ictus. Altogether, 16,054 chemical analyses from 1647 dialysate samples were performed. Concentrations of the energy-related substances lactate, pyruvate, glucose, and hypoxanthine were measured, and the lactate/pyruvate ratio was calculated. The excitatory amino acids glutamate and aspartate were measured. The microdialysis data were matched with computerized tomography findings, clinical course, and outcome. The results support the concepts that microdialysis is a promising tool for chemical monitoring of the human brain and that extracellular fluid levels of lactate, lactate/pyruvate ratio, glucose, hypoxanthine, and glutamate are useful markers of disturbances in brain energy metabolism in neurointensive care patients. These results have generated a working hypothesis that the pattern of these extracellular markers may help differentiate between various causes of energy perturbations, such as hypoxia and different degrees of ischemia. The correlation between the dialysate levels of excitatory amino acids and outcome supports the concept of glutamate receptor overactivation in acute human brain injury.

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22

Fountain, N. B. "Is it time for routine EEG monitoring after intracerebral hemorrhage?" Neurology 69, no. 13 (September 24, 2007): 1312–13. http://dx.doi.org/10.1212/01.wnl.0000285495.12791.62.

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23

Kiphuth, Ines C., Hagen B. Huttner, Lorenz Breuer, Stefan Schwab, and Martin Köhrmann. "Sonographic Monitoring of Midline Shift Predicts Outcome after Intracerebral Hemorrhage." Cerebrovascular Diseases 34, no. 4 (2012): 297–304. http://dx.doi.org/10.1159/000343224.

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24

Meucci, Giuseppe, and Roberto Catalani. "Nosology of non traumatic intracerebral haemorrhage." Reviews in Health Care 2, no. 1S (June 10, 2011): 15. http://dx.doi.org/10.7175/rhc.4721s15-18.

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Spontaneous intracranial haemorrhage is a serious medical emergency, representing the 20% of all the hospitalisations for stroke. It requires rapid diagnosis and management. This article offers an overview of this disease. Causes are listed, such as rupture of an aneurysm or arteriovenous malformation, amyloid angiopathy, lipohyalinosis, and microaneurysms. Neuroimaging studies, such as CT and MRI, are required for diagnosis; in addition neuroimaging can be useful in understanding the type of haemorrhage, its aetiology, and its pathophysiology. The treatment, along with surgery, includes hypertension and intracranial pressure control, glucose and temperature monitoring, and the administration of osmotic agents.

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25

Meucci, Giuseppe, and Roberto Catalani. "Nosology of non traumatic intracerebral haemorrhage." Reviews in Health Care 2, no. 1S (June 10, 2011): 15–18. http://dx.doi.org/10.7175/rhc.v2i1s.47.

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Анотація:

Spontaneous intracranial haemorrhage is a serious medical emergency, representing the 20% of all the hospitalisations for stroke. It requires rapid diagnosis and management. This article offers an overview of this disease. Causes are listed, such as rupture of an aneurysm or arteriovenous malformation, amyloid angiopathy, lipohyalinosis, and microaneurysms. Neuroimaging studies, such as CT and MRI, are required for diagnosis; in addition neuroimaging can be useful in understanding the type of haemorrhage, its aetiology, and its pathophysiology. The treatment, along with surgery, includes hypertension and intracranial pressure control, glucose and temperature monitoring, and the administration of osmotic agents.

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26

Dey, Mahua, Agnieszka Stadnik, and Issam A. Awad. "Spontaneous Intracerebral and Intraventricular Hemorrhage." Neurosurgery 74, suppl_1 (February 1, 2014): S142—S150. http://dx.doi.org/10.1227/neu.0000000000000221.

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Abstract Optimal management of spontaneous intracerebral hemorrhage (ICH) remains one of the highly debated areas in the field of neurosurgery. Earlier studies comparing open surgical intervention with best medical management failed to show a clear benefit. More recent experience with minimally invasive techniques has shown greater promise. Well-designed phase II trials have confirmed the safety and preliminary treatment effect of thrombolytic aspiration and clearance of spontaneous ICH and associated intraventricular obstructive hemorrhage. Those trials are reviewed, including respective protocols and technical nuances, and lessons learned regarding patient selection, the concept of hemorrhage stabilization, optimization of the surgical procedure, and thrombolytic dosing decisions. These concepts have been incorporated in the design of ongoing definite phase III randomized trials (MISTIE and CLEAR) funded by the National Institutes of Health. These are presented including the role of surgical leadership in the training and monitoring of the surgical task and quality assurance. The impact of these techniques on neurosurgical practice is discussed.

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27

Mellergård, Pekka, and Carl-Henrik Nordström. "Intracerebral Temperature in Neurosurgical Patients." Neurosurgery 28, no. 5 (May 1, 1991): 709–13. http://dx.doi.org/10.1227/00006123-199105000-00012.

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Abstract Recent laboratory results have indicated that the ischemic brain is very sensitive to minor variations in temperature. This has created new interest in hypothermia and brain temperature. There is, however, very little information available regarding human intracerebral temperature and its relation to body core temperature during normal and pathological circumstances. We therefore made continuous measurements of the temperature of the lateral ventricle in 15 neurosurgical patients utilizing a newly developed technique with copper-constantan thermocouples introduced through a plastic catheter also used for monitoring intracranial pressure. The intraventricular temperature was higher than the rectal temperature during approximately 90% of all measurements. The largest temperature gradient measured was 2.3°C. Usually the difference between the temperature of the rectum and the brain was much smaller, the mean value being 0.33°C. For the patients in the most severe condition, the rectal temperature was sufficiently close to the brain temperature to afford a reliable basis for adequate clinical judgment.

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28

Pradhan, Aseem, Udgam Baxi, and Girish Menon. "Spontaneous Intracerebral Haemorrhage during Pregnancy: Management Concerns." Journal of Cerebrovascular Sciences 11, no. 1 (January 2023): 46–49. http://dx.doi.org/10.4103/jcvs.jcvs_2_23.

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ABSTRACT Spontaneous intracerebral haematomas in the obstetric setting pose considerable challenges. Decision-making involves deliberations on the gestational age, neurological status of the mother, clot volume, underlying pathology, timing of surgery if indicated, maternal positioning during neurosurgery, anaesthesiologic strategies, monitoring of the pregnancy during surgery and the mode of delivery. We present the case history of a 36-year old female homemaker (G2 P1 L1) who presented to the emergency in her 29th week of gestation with a large putaminal bleed. The report discusses the management and ethical dilemmas encountered during the management of obstetric patients with spontaneous intracerebral hematomas.

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29

Helbok, Raimund, Alois Josef Schiefecker, Christian Friberg, Ronny Beer, Mario Kofler, Paul Rhomberg, Iris Unterberger, et al. "Spreading depolarizations in patients with spontaneous intracerebral hemorrhage: Association with perihematomal edema progression." Journal of Cerebral Blood Flow & Metabolism 37, no. 5 (July 21, 2016): 1871–82. http://dx.doi.org/10.1177/0271678x16651269.

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Pathophysiologic mechanisms of secondary brain injury after intracerebral hemorrhage and in particular mechanisms of perihematomal-edema progression remain incompletely understood. Recently, the role of spreading depolarizations in secondary brain injury was established in ischemic stroke, subarachnoid hemorrhage and traumatic brain injury patients. Its role in intracerebral hemorrhage patients and in particular the association with perihematomal-edema is not known. A total of 27 comatose intracerebral hemorrhage patients in whom hematoma evacuation and subdural electrocorticography was performed were studied prospectively. Hematoma evacuation and subdural strip electrode placement was performed within the first 24 h in 18 patients (67%). Electrocorticography recordings started 3 h after surgery (IQR, 3–5 h) and lasted 157 h (median) per patient and 4876 h in all 27 patients. In 18 patients (67%), a total of 650 spreading depolarizations were observed. Spreading depolarizations were more common in the initial days with a peak incidence on day 2. Median electrocorticography depression time was longer than previously reported (14.7 min, IQR, 9–22 min). Postoperative perihematomal-edema progression (85% of patients) was significantly associated with occurrence of isolated and clustered spreading depolarizations. Monitoring of spreading depolarizations may help to better understand pathophysiologic mechanisms of secondary insults after intracerebral hemorrhage. Whether they may serve as target in the treatment of intracerebral hemorrhage deserves further research.

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30

Morton, Ryan, Timothy H. Lucas, Andrew Ko, Samuel R. Browd, Richard G. Ellenbogen, and R. M. Chesnut. "Intracerebral Abscess Associated With the Camino Intracranial Pressure Monitor: Case Report and Review of the Literature." Neurosurgery 71, no. 1 (August 19, 2011): E193—E198. http://dx.doi.org/10.1227/neu.0b013e318232e250.

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Abstract BACKGROUND AND IMPORTANCE: Intracranial pressure (ICP) monitoring is a mainstay in the management of traumatic brain injury. Large investigations have validated the safety and efficacy of ICP monitors in comatose patients. Clinically relevant infections are extremely rare and cerebral abscess has never been reported with the Camino device. We describe an exceptional case of a life-threatening intracerebral abscess from an intraparenchymal ICP monitor. CLINICAL PRESENTATION: A 35-month-old child required 7 days of ICP monitoring after a fall from a 2-story window. His hospital course was complicated by severe airway edema treated, in part, with high-dose corticosteroid therapy for a total of 10 days. Two weeks later, the patient deteriorated acutely owing to a large intracerebral abscess under the previous ICP monitor site. Urgent craniotomy with evacuation of the abscess was performed on 2 separate occasions. Cultures grew methicillin-sensitive Staphylococcus aureus, which was treated with long-term antibiotics. At the 3-month follow-up, the patient was meeting age-appropriate milestones without focal deficits. CONCLUSION: To the best of our knowledge, this is the first report describing an intracerebral abscess as a complication from an intraparenchymal pressure monitor. Corticosteroid therapy may have constituted an independent risk factor for the ICP monitor--associated infection, as well as reinsertion of the ICP monitoring device at the same site. That this is the first reported parenchymal infectious complication underscores the safety of this device with respect to infection. When reinsertion of a parenchymal monitor is considered, a new site should be chosen.

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31

Korfhagen, Joseph J., Madhuvanthi A. Kandadai, Joseph F. Clark, Opeolu Adeoye, and George J. Shaw. "A prototype device for non-invasive continuous monitoring of intracerebral hemorrhage." Journal of Neuroscience Methods 213, no. 1 (February 2013): 132–37. http://dx.doi.org/10.1016/j.jneumeth.2012.12.007.

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32

KAGAWA, Kota, Koji IIDA, Akira HASHIZUME, Go SEYAMA, Akitake OKAMURA, Rofat ASKORO, and Nobutaka HORIE. "Retained Intracerebral Depth Electrode after Stereotactic Electroencephalography Monitoring: A Case Report." NMC Case Report Journal 11 (December 31, 2024): 49–53. http://dx.doi.org/10.2176/jns-nmc.2023-0242.

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Ruemmler, Robert, Veselina Moravenova, Sandy Al-Butmeh, Kimiko Fukui-Dunkel, Eva-Verena Griemert, and Alexander Ziebart. "A novel non-invasive nociceptive monitoring approach fit for intracerebral surgery: a retrospective analysis." PeerJ 12 (January 16, 2024): e16787. http://dx.doi.org/10.7717/peerj.16787.

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Background Measuring depth of anesthesia during intracerebral surgery is an important task to guarantee patient safety, especially while the patient is fixated in a Mayfield-clamp. Processed electro-encephalography measurements have been established to monitor deep sedation. However, visualizing nociception has not been possible until recently and has not been evaluated for the neurosurgical setting. In this single-center, retrospective observational analysis, we routinely collected the nociceptive data via a nociception level monitor (NOL®) of 40 patients undergoing intracerebral tumor resection and aimed to determine if this monitoring technique is feasible and delivers relevant values to potentially base therapeutic decisions on. Methods Forty patients (age 56 ± 18 years) received total intravenous anesthesia and were non-invasively connected to the NOL® via a finger clip as well as a bispectral-index monitoring (BIS®) to confirm deep sedation. The measured nociception levels were retrospectively evaluated at specific time points of nociceptive stress (intubation, Mayfield-positioning, incision, extubation) and compared to standard vital signs. Results Nociceptive measurements were successfully performed in 35 patients. The largest increase in nociceptive stimulation occurred during intubation (NOL® 40 ± 16) followed by Mayfield positioning (NOL® 39 ± 16) and incision (NOL® 26 ± 12). Correlation with BIS measurements confirmed a sufficiently deep sedation during all analyzed time points (BIS 45 ± 13). Overall, patients showed an intraoperative NOL® score of 10 or less in 56% of total intervention time. Conclusions Nociceptive monitoring using the NOL® system during intracerebral surgery is feasible and might yield helpful information to support therapeutic decisions. This could help to reduce hyperanalgesia, facilitating shorter emergence periods and less postoperative complications. Prospective clinical studies are needed to further examine the potential benefits of this monitoring approach in a neurosurgical context. Trial registration German trial registry, registration number DRKS00029120.

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Li, Lingzhi, Pingping Wang, Haiping Zhao, and Yumin Luo. "Noncoding RNAs and Intracerebral Hemorrhage." CNS & Neurological Disorders - Drug Targets 18, no. 3 (April 26, 2019): 205–11. http://dx.doi.org/10.2174/1871527318666190204102604.

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Background & Objective:Intracerebral hemorrhage (ICH) is the most devastating subtype of stroke, for which there are few effective interventions. Computed tomography is accepted as the gold standard for diagnosis, whereas surgical evacuation is the main treatment for ICH. However, in emergency rooms, time is limited and information regarding a patient’s clinical status or tolerance is typically not available. Many studies over the last decade have investigated the fundamental mechanisms of ICH and especially hematoma, which not only cause physical damage but also release toxins that have detrimental effects. However, there remain many gaps in our understanding of ICH. Compared to ischemic stroke, there is little known about the ICH pathogenesis and treatment options, and few specific biomarkers are available for monitoring disease progression, which include hematoma enlargement and perihematoma edema. Noncoding RNAs (ncRNAs) are involved in various biological processes and are potential biomarkers and therapeutic tools in central nervous system diseases. Recent studies have examined the role of ncRNAs including microRNAs, long noncoding RNAs, and circular RNAs—the three main subgroups associated with stroke—in ICH models. A deeper understanding of the functions of ncRNAs in different biological processes can provide a basis for developing more effective therapeutic strategies to prevent neuronal damage following ICH. In clinical settings, ncRNAs can serve as biomarkers for predicting the degree of injury resulting from ICH.Conclusion:In this review, we discuss the current state of knowledge of the role of ncRNAs in ICH.

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Calon, Barthélémy, Guy Freys, Anne Launoy, Patrick Boyer, Jean Tongio, and Thierry Pottecher. "Early discovery of a traumatic carotid-cavernous sinus fistula by jugular venous oxygen saturation monitoring." Journal of Neurosurgery 83, no. 5 (November 1995): 910–11. http://dx.doi.org/10.3171/jns.1995.83.5.0910.

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✓ This report describes the early diagnosis, due to an acute increase of jugular venous oxygen saturation occurring 20 hours after trauma, of a traumatic carotid-cavernous sinus fistula after severe head injury. Hyperemia in severe head injury should be treated only after an intracerebral arteriovenous communication has been excluded.

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NORDMARK, J., S. RUBERTSSON, E. MÖRTBERG, P. NILSSON, and P. ENBLAD. "Intracerebral monitoring in comatose patients treated with hypothermia after a cardiac arrest." Acta Anaesthesiologica Scandinavica 53, no. 3 (March 2009): 289–98. http://dx.doi.org/10.1111/j.1399-6576.2008.01885.x.

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Yu, Yao, Jun Wu, Wei Zhao, Lei Zhao, Chunpeng Zhu, and Xuguang Gao. "Calibrated automated thrombography for monitoring coagulation function in patients with intracerebral haemorrhage." Journal of International Medical Research 43, no. 3 (May 6, 2015): 316–25. http://dx.doi.org/10.1177/0300060514565801.

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38

Wu, Dan, Jinge Yang, Guang Zhang, and Huabei Jiang. "Noninvasive in vivo monitoring of collagenase induced intracerebral hemorrhage by photoacoustic tomography." Biomedical Optics Express 8, no. 4 (March 21, 2017): 2276. http://dx.doi.org/10.1364/boe.8.002276.

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39

Engelmann, Mario, Mike Ludwig, and Rainer Landgraf. "Simultaneous Monitoring of Intracerebral Release and Behavior: Endogenous Vasopressin Improves Social Recognition." Journal of Neuroendocrinology 6, no. 4 (August 1994): 391–95. http://dx.doi.org/10.1111/j.1365-2826.1994.tb00598.x.

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40

Salci, Kontsantin, Pelle Nilsson, Timothy Howells, Elisabeth Ronne-Engström, Ian Piper, Charles F. Contant, and Per Enblad. "Intracerebral Microdialysis and Intracranial Compliance Monitoring of Patients with Traumatic Brain Injury." Journal of Clinical Monitoring and Computing 20, no. 1 (February 2006): 25–31. http://dx.doi.org/10.1007/s10877-006-2864-x.

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41

Nath, Fredrik P., Alistair Jenkins, A. David Mendelow, David I. Graham, and Graham M. Teasdale. "Early hemodynamic changes in experimental intracerebral hemorrhage." Journal of Neurosurgery 65, no. 5 (November 1986): 697–703. http://dx.doi.org/10.3171/jns.1986.65.5.0697.

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✓ A model of experimental intracerebral hemorrhage is described in which carefully controlled volumes of autologous blood were injected at arterial pressure into the caudate nucleus of the rat. A comparison of intracranial pressure changes and local cerebral blood flow (CBF) was made between three groups of rats, each receiving different injection volumes, and sham-operated control rats by monitoring intraventricular pressure and by obtaining quantitative autoradiographic measurements of CBF within 1 minute of the experimental hemorrhage. Cerebral blood flow was reduced both around the hematoma and in the surrounding brain. This change was strongly volume-dependent and was not accompanied by significant alterations in cerebral perfusion pressure. This finding suggests that the degree of ischemia at the time of an intracerebral bleed depends on the size of the lesion, and implicates local squeezing of the microcirculation by the hematoma, rather than a generalized alteration in perfusion pressure, as the cause of ischemia.

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Tolstykh, Nadezhda V., Alexander F. Gurchin, Nadezhda Yu Koroleva, and Igor D. Stolyarov. "Clinical and neurophysiological peculiarities of tumor-related epilepsy." Medical academic journal 20, no. 2 (September 2, 2020): 87–96. http://dx.doi.org/10.17816/maj33822.

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Detection and correction of structural tumor-associated epilepsy remain relevant at the present time. Seizures occur in 7590% of cases in patients with gliomas of malignancys various degrees. The aim of this work was to clarify the links of pathogenesis and clinical and neurophysiological features of structural epilepsy in intracerebral tumors. Materials and methods. We examined 23 patients with intracerebral tumors and symptomatic epilepsy. Results. Epileptiform activity was registered in 2 or more regions in more than half of the patients 12 people (52.18%), and 7 of them (58.3%) it spread to neighboring leads. No association was found between the size of the tumor and the number of attacks. Conclusions. Grade III tumors predominate among patients with tumor-related epilepsy. In this population with a high frequency after surgery, both tumor control and freedom from seizures can be achieved. It is necessary to manage this group of patients after surgery with regular neurophysiological monitoring (MRI, positron-emission tomography and video-EEG monitoring) to correct antiepileptic therapy and maintain a high level of quality of life.

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Silva Blas, Yolanda, Michael N. Diringer, Benjamin Lo, Jaime Masjuan, Natalia Pérez de la Ossa, Matthew Cardinal, Florence Yong, Tong Zhu, Gang Li, and Steven Arkin. "Phase 1b Study to Evaluate Safety, Tolerability, and Maximum Tolerated Dose of PF-05230907 for Intracerebral Hemorrhage." Stroke 52, no. 1 (January 2021): 294–98. http://dx.doi.org/10.1161/strokeaha.120.029789.

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Background and Purpose: This study aimed to determine the maximum tolerated dose and to evaluate the overall safety and tolerability of single doses of PF-05230907 in subjects with acute intracerebral hemorrhage. Methods: Individuals presenting with intracerebral hemorrhage were enrolled in a phase 1, multicenter, open-label clinical trial. A Bayesian modified continual reassessment method design based on treatment-emergent thromboembolic or ischemic events was adopted. Sequential dosing, an external data monitoring committee, and prespecified stopping rules were incorporated as safeguards. Results: Twenty-one subjects received PF-05230907. The mean (±SD) age in years and intracerebral hemorrhage volume in mL at baseline were 62 (±9) and 18 (±11), respectively. Two treatment-emergent thromboembolic or ischemic events occurred (deep vein thrombosis and cerebral ischemia), in the 30 μg/kg dose group. There were no other clear drug-related toxicities at dose levels ranging from 5 to 30 μg/kg. At the time of study termination, the maximum tolerated dose was estimated to be 24 μg/kg, with a mean fitted dose-toxicity estimate of 11.9% (95% CI, 1.2%–27.4%). Conclusions: Single doses of PF-05230907 appeared to be tolerated across a range of doses in the intracerebral hemorrhage population, with thrombotic events observed only at the highest dose level tested. Recruitment within the recommended therapeutic window of opportunity remains a challenge. Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT02687191.

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Nagy, B., I. Szabó, G. Takács, B. Csetényi, E. Hormay, and Z. Karádi. "Impaired glucose tolerance after streptozotocin microinjection into the mediodorsal prefrontal cortex of the rat." Physiology International 103, no. 4 (December 22, 2016): 403–12. http://dx.doi.org/10.1556/2060.103.2016.4.5.

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The mediodorsal prefrontal cortex (mdPFC) is a key structure of the central glucose-monitoring (GM) neural network. Previous studies indicate that intracerebral streptozotocin (STZ) microinjection-induced destruction of local chemosensory neurons results in feeding and metabolic alterations. The present experiments aimed to examine whether STZ microinjection into the mdPFC causes metabolic deficits. To do so, glucose tolerance test (GTT) and measurements of plasma metabolites were performed in STZ-treated or control rats. Intraperitoneal D-glucose load was delivered 20 min or 4 weeks following the intracerebral microinjection of STZ or saline (acute or subacute GTT, respectively). The STZ-treated rats displayed acute glucose intolerance: at the 120th min of the test, blood glucose level of these rats was significantly higher than that of the ones in the control group. When determining the plasma level of various metabolites, 30 min following the intracerebral STZ or saline microinjection, the triglyceride concentration of the STZ-treated rats was found to be reduced compared with that of the control rats. The GM neurons of the mdPFC are suggested to be involved in the organization of complex metabolic processes by which these chemosensory cells contribute to adaptive control mechanisms of the maintenance of homeostasis.

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Long, Zhifeng, Lie-Ping Li, Tracey Grooms, Christopher Lockey, Kellie Nader, Ihor Mychkovsky, Stephen Mueller, et al. "Biosafety Monitoring of Patients Receiving Intracerebral Injections of Murine Retroviral Vector Producer Cells." Human Gene Therapy 9, no. 8 (May 20, 1998): 1165–72. http://dx.doi.org/10.1089/hum.1998.9.8-1165.

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46

Abdennour, L., D. De Bels, K. Van Boxen, S. Dadoun, P. Coriat, and L. Puybasset. "Is the EEG bispectral index valid for patient monitoring in awake intracerebral tumorectomy?" European Journal of Anaesthesiology 18, Supplement 21 (2001): 73. http://dx.doi.org/10.1097/00003643-200100001-00260.

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Ko, Sang-Bae, H. Alex Choi, Gunjan Parikh, Raimund Helbok, J. Michael Schmidt, Kiwon Lee, Neeraj Badjatia, Jan Claassen, E. Sander Connolly, and Stephan A. Mayer. "Multimodality Monitoring for Cerebral Perfusion Pressure Optimization in Comatose Patients With Intracerebral Hemorrhage." Stroke 42, no. 11 (November 2011): 3087–92. http://dx.doi.org/10.1161/strokeaha.111.623165.

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Wårdell, Karin, Patric Blomstedt, Johan Richter, Johan Antonsson, Ola Eriksson, Peter Zsigmond, A. Tommy Bergenheim, and Marwan I. Hariz. "Intracerebral Microvascular Measurements during Deep Brain Stimulation Implantation using Laser Doppler Perfusion Monitoring." Stereotactic and Functional Neurosurgery 85, no. 6 (2007): 279–86. http://dx.doi.org/10.1159/000107360.

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49

Vespa, Paul M., Nestor Gonzalez, Chelsea S. Kidwell, Jeffrey L. Saver, Marc Nuwer, Thomas Glenn, and Neil Martin. "Detection of critical oligemia in patients with traumatic intracerebral hemorrhage using continuous quantitative electroencephalography and cerebral microdialysis." Stroke 32, suppl_1 (January 2001): 338. http://dx.doi.org/10.1161/str.32.suppl_1.338.

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121 Introduction: Serial changes in cerebral blood flow after intracerebral hemorrhage may influence tissue viability in regions surrounding the hematoma. Non invasive monitoring may assist titration of systolic blood pressure. Purpose: To determine if continuous quantitative electroencephalography percent alpha variability(EEGPAV)can discriminate areas of critically reduced cerebral blood flow (CBF). Methods: Ten patients with traumatic intracerebral hemorrhage underwent combined monitoring of cerebral microdialysis, EEGPAV, and intermittent xenon-computerized tomograhpy to determine if EEGPAV monitoring could determine and monitor cellular distress in the context of oligemia. Critical oligemia was defined as CBF < 25. Time and regional matched samples of EEG, microdialysis and CBF were used to correlate across modalities. Regions adjacent to the hematoma only were studied. Results: Six patients had regional CBF < 25 and 4 > 30 cc/100gm/min. In the low CBF group, the mean regional EEGPAV was 0.11 ± 0.4 compared to 0.22 ± 0.3 in the high-normal CBF group(p < 0.01). The low CBF group had lower extracellular levels of glucose (0.33±0.27) compared to the high-normal CBF group (1.9±1.0) (p < 0.001). Extracellular glutamate levels were higher in the low CBF group (14.5 ±23 uM) compared to the high-normal CBF group (1.34±0.8) (p < 0.001). Lactate and glycerol levels were not statistically different between groups (p < 0.8) Conclusion: EEGPAV can discriminate brain regions that have critical oligemia and neurochemichal evidence of cellular distress.

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Vermilyea, Scott C., Jianfeng Lu, Miles Olsen, Scott Guthrie, Yunlong Tao, Eva M. Fekete, Marissa K. Riedel, et al. "Real-Time Intraoperative MRI Intracerebral Delivery of Induced Pluripotent Stem Cell-Derived Neurons." Cell Transplantation 26, no. 4 (April 2017): 613–24. http://dx.doi.org/10.3727/096368916x692979.

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Induced pluripotent stem cell (iPSC)-derived neurons represent an opportunity for cell replacement strategies for neurodegenerative disorders such as Parkinson's disease (PD). Improvement in cell graft targeting, distribution, and density can be key for disease modification. We have previously developed a trajectory guide system for real-time intraoperative magnetic resonance imaging (RT-IMRI) delivery of infusates, such as viral vector suspensions for gene therapy strategies. Intracerebral delivery of iPSC-derived neurons presents different challenges than viral vectors, including limited cell survival if cells are kept at room temperature for prolonged periods of time, precipitation and aggregation of cells in the cannula, and obstruction during injection, which must be solved for successful application of this delivery approach. To develop procedures suitable for RT-IMRI cell delivery, we first performed in vitro studies to tailor the delivery hardware (e.g., cannula) and defined a range of parameters to be applied (e.g., maximal time span allowable between cell loading in the system and intracerebral injection) to ensure cell survival. Then we performed an in vivo study to evaluate the feasibility of applying the system to nonhuman primates. Our results demonstrate that the RT-IMRI delivery system provides valuable guidance, monitoring, and visualization during intracerebral cell delivery that are compatible with cell survival.

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