PMID: 8971104Dec 1, 1996Paper

Acute intraoperative brain herniation during elective neurosurgery: pathophysiology and management considerations

Journal of Neurology, Neurosurgery, and Psychiatry
I R Whittle, R Viswanathan

Abstract

To describe operative procedures, pathophysiological events, management strategies, and clinical outcomes after acute intraoperative brain herniation during elective neurosurgery. Review of clinical diagnoses, operative events, postoperative CT findings, intracranial pressure, and arterial blood pressure changes and outcomes in a series of patients in whom elective neurosurgery had to be abandoned because of severe brain herniation. Acute intraoperative brain herniation occurred in seven patients. In each patient subarachnoid or intraventricular haemorrhage preceded the brain herniation. The haemorrhage occurred after intraoperative aneurysm rupture either before arachnoidal dissection (three) or during clip placement (one); after resection of 70% of a recurrent hemispheric astroblastoma; after resection of a pineal tumour; and after a stereotactic biopsy of an AIDS lesion. In all patients the procedure was abandoned because of loss of access to the intracranial operating site, medical measures to control intracranial pressure undertaken (intravenous thiopentone), an intraventricular catheter or Camino intracranial pressure monitor inserted, and CT performed immediately after scalp closure. The patients were transferred to an i...Continue Reading

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Citations

Jun 5, 2004·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·D P MuzumdarS Fattepurkar
Aug 14, 2010·Journal of Neurosurgical Anesthesiology·Hemant BhagatNavneet Singla
May 2, 2008·Journal of the American Veterinary Medical Association·Amanda L AbelsonAlicia Z Karas
Apr 22, 2011·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Michael E SughrueAndrew T Parsa
Mar 31, 2009·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Kathleen Joy Khu, Wai Hoe Ng
Apr 29, 2016·British Journal of Anaesthesia·J LiL Meng
Feb 8, 2020·Zhurnal voprosy neĭrokhirurgii imeni N. N. Burdenko·A S KulikovA Yu Lubnin
Nov 22, 2016·Brain Tumor Research and Treatment·Youngbo Shim, Sang Hyung Lee
Jan 30, 2020·Forensic Science, Medicine, and Pathology·Vladimir ŽivkovićSlobodan Nikolić

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