Cerebral microdialysis and P(ti)O2 for neuro-monitoring before decompressive craniectomy.
We report the case of a young patient with post-traumatic, intractable, intracranial hypertension leading to craniectomy. This intracranial hypertension was preceded by focal signs of ischemia diagnosed through P(ti)O2 monitoring and cerebral microdialysis, and occurred a few hours prior to a decrease in cerebral perfusion pressure below 60 mmHg. The neurological outcome was satisfactory with a Glasgow Outcome Scale of 4 at 3 months. We discuss the potential interest of such neuro-monitoring to determine the optimal time for performing a craniectomy.
Boret
H
H
Department of Anesthesiology and Intensive Care, Sainte-Anne Teaching Military Hospital, Toulon-Naval, France. hb-boret@wanadoo.fr
Fesselet
J
J
Meaudre
E
E
Gaillard
P-E
PE
Cantais
E
E
D000293:Adolescent; D001930:Brain Injuries / Q000150:complications / Q000601:surgery*; D003399:Craniotomy / Q000379:methods*; D019299:Decompression, Surgical / Q000379:methods*; D015600:Glasgow Coma Scale; D006801:Humans; D019586:Intracranial Hypertension / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D007427:Intracranial Pressure; D017551:Microdialysis / Q000379:methods*; D008991:Monitoring, Physiologic / Q000379:methods; D010100:Oxygen / Q000032:analysis*; D010313:Partial Pressure; D013997:Time Factors
D010100:Oxygen