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      Aspectos técnicos da monitorização da pressão intracraniana pelo método subaracnóideo no traumatismo craniencefálico grave Translated title: Technical aspects of intracranial pressure monitoring by subarachnoid method in severe head injury

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          Abstract

          Foram analisados prospectivamente 206 pacientes com traumatismo craniencefálico (TCE) grave (8 pontos ou menos na Escala de Coma de Glasgow), internados na Unidade de Terapia Intensiva do Hospital das Clínicas da Universidade Estadual de Campinas. Após avaliação por tomografia computadorizada de crânio (TC), 72 pacientes necessitaram de tratamento neurocirúrgico. Todos os pacientes foram submetidos à monitorização contínua da pressão intracraniana (PIC) pelo método subaracnóideo (11 com parafuso metálico e 195 com cateter plástico). Os níveis de PIC foram registrados continuamente na tela do monitor, sendo os seus valores de final de hora anotados em ficha padronizada. Todos os pacientes foram tratados segundo um protocolo orientado pelos níveis da PIC. Não foram observadas complicações hemorrágicas ou hematomas intracranianos relacionados ao método de monitorização em TC de controle. Para controle de infecções intracranianas, foram colhidas amostras de líquido cefalorraquidiano através de punção lateral C1-C2 em 66 pacientes com PIC abaixo de 20 mm Hg, sendo positivas as culturas para Acinetobacter sp em 2 pacientes. O resultado final na alta hospitalar mostrou 75 (36,40%) óbitos e 131 (63,6%) sobreviventes. Os níveis de PIC influenciaram significativamente o resultado final (p<0,001), o que confirma a importância de sua monitorização e controle no tratamento do TCE grave. O método subaracnóideo para a monitorização contínua da PIC foi considerado aplicável, seguro, simples, de baixo custo e útil para a orientação do tratamento. A metodologia de registro da PIC foi considerada útil e prática. Apesar dos avanços técnicos nesta área, o método subaracnóideo mostrou-se uma alternativa bastante viável para a monitorização da PIC em pacientes com traumatismo craniencefálico grave.

          Translated abstract

          Two hundred and six patients with severe head injury (Glasgow Coma Scale of 8 points or less after nonsurgical resuscitation on admission), managed at Intensive Care Unit-Hospital das Clínicas - Universidade Estadual de Campinas were prospectively analysed. All patients were assessed by CT scan and 72 required neurosurgical intervention. All patients were continuously monitored to evaluate intracranial pressure (ICP) levels by a subarachnoid device (11 with subarachnoid metallic bolts and 195 with subarachnoid polyvinyl catheters). The ICP levels were continuously observed in the bedside pressure monitor display and their end-hour values were recorded in a standard chart. The patients were managed according to a standard protocol guided by the ICP levels. There were no intracranial haemorrhagic complications or hematomas due the monitoring method. Sixty six patients were punctured by lateral C1-C2 technique to assess infectious complications and 2 had positive cerebrospinal fluid samples for Acinetobacter sp. The final results measured at hospital discharge showed 75 deaths (36,40%) and 131 (63,60%) survivors. ICP levels had significantly influenced the final results (p<0,001). The subarachnoid method to continuously assess the ICP levels was considered aplicable, safe, simple, low cost and useful to advise the management of the patients. The ICP record methodology was practical and useful. Despite the current technical advances the subarachnoid method was considered viable to assess the ICP levels in severe head injury.

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          Continuous recording and control of ventricular fluid pressure in neurosurgical practice.

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            • Record: found
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            • Article: not found

            Lateral cervical puncture: an alternative to lumbar puncture

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              • Record: found
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              • Article: not found

              Susceptibility of brain and skin to bacterial challenge.

              The brain is a uniquely protected organ. Once the protective barriers are overcome, the brain is susceptible to bacterial infection. Using a reproducible rat model, the susceptibility of brain tissue to challenge by S. aureus or E. coli was quantitatively compared to that of skin. Brain was significantly more susceptible to the presence of bacteria than was the skin of the scalp. The development of infection in skin required at least 10(5) organisms, while brain infection could be produced with as few as 100 organisms.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                anp
                Arquivos de Neuro-Psiquiatria
                Arq. Neuro-Psiquiatr.
                Academia Brasileira de Neurologia - ABNEURO (São Paulo )
                1678-4227
                December 2001
                : 59
                : 4
                : 895-900
                Affiliations
                [1 ] Universidade Estadual de Campinas Brazil
                [2 ] Universidade Estadual de Campinas Brazil
                Article
                S0004-282X2001000600011
                10.1590/S0004-282X2001000600011
                67204089-f662-4ea3-a707-e71c5952019d

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0004-282X&lng=en
                Categories
                NEUROSCIENCES
                PSYCHIATRY

                Neurosciences,Clinical Psychology & Psychiatry
                head injury,intracranial pressure,Glasgow coma scale,coma,traumatismo craniencefálico,pressão intracraniana,escala de coma de Glasgow

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