Any Notes to the Pathophysiology of Secondary Cerebral Injury

Overview

Authors retrospectively analysed morphologic (CT scan) and multimodal monitoring data in a group of 31 patients with cerebral injury. On theinitial CT scan cerebral edema was apparent in 79 % cases. In contrast with this observation, in course of 48 hours from injury ICP value over 20mmHg was found in 5 % and SjO2 value below 60 % was found in 59 % measurements. In SjO2 < 60 % data set significantly lower values of paCO2and significantly higher occurrence of CPP values below CPPcrit were found comparing to SjO2 > 60 % data set. Analysing causes of CPP fall belowCPPcrit 8 % participation of isolated ICP rise over ICPcrit and 67 % participation of MAP fall below MAPcrit were found. On the basis of this analysisauthors presume that ICP rise is not a cause but result of secondary cerebral injury.

Key words:
cerebral edema – intracranial pressure