title: [Monitoring of intracranial pression in acute neurotrauma by extra-dural screw (author's transl)].
abstract: These data emphasize the interest of the study, in acute traumatic comatose, of the brain-stem reflexes and level of coma (Plum, Posner, Perez-Dominguez, Barge, Espagno) and the monitoring of the intracranial pression (ICP) by extra-dural screw (Vries, de Rougemont, J. Brunon). It is possible to describe: 1)The bilateral hemispherical contusions: with cortico-subcortical level and bilateral decorticate comatose. The normal brain-stem reflexes (N.B.S.R.) are presents. The monitoring of ICP allows to separate the reversible bilateral hemispherical contusions (ICP can present unstable recording during 3 days with pressure-waves--B waves--or to be stable (between 10--15 mm Hg)), from the severe bilateral contusions with rostro-caudal evolution and "plateau-waves". 2) The brain-stem contusions: the clinical level is often a mesencephalic level with decerebrate rigidity and N.B.S.R. +/- (Automatic Eye Movements). In severe injury the ICP is increased and unstable with A waves. In reversible brain-stem contusions the ICP is often stable and low with arteriography and ventriculography insignificant. 3) The associated contusions: In general, the head injuries of this group are alternatively decorticate or on decerebrate rigidity ("ambiguous reaction"). In the severe associated contusions the ICP shows A waves. In reversible contusions ICP is stable with normal supratentorial angiogramm and ventriculography.
mesh_terms: D001930:Brain Injuries / Q000150:complications / Q000503:physiopathology*; D001933:Brain Stem / Q000503:physiopathology; D003128:Coma / Q000209:etiology / Q000503:physiopathology*; D004824:Epidural Space; D006801:Humans; D007427:Intracranial Pressure; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D011379:Prognosis; D012021:Reflex, Abnormal / Q000209:etiology
vernacular_title: Monitorage de pression intra-crânienne en neuro-traumatologie aiguë par capteur extra-dural.