Summary
Intracranial pressure (ICP) differences, change of local blood flow (CBF) using the hydrogen clearance technique, change in the somatosensory evoked potential (SEP) to median nerve stimulation and pupillary size were investigated during progressive elevation of the ICP (using an extradural balloon) in 6 anaesthetized baboons. CBF was measured in the frontal cortex, somatosensory cortex, thalamus (nucleus ventralis posterior lateralis—VPL), medial lemniscus (ML), lateral lemniscus (LL) and caudate nucleus (CN). Conduction along the somatosensory pathway between C 2 at the neck and VPL was compared with conduction between VPL and primary somatosensory cortex. The amplitude of the cortical SEP was also studied.
ICP gradients between hemispheres developed as the pressure was increased to in excess of 50 mm Hg. CBF was significantly reduced from control in the cortex and VPL on the side ipsilateral to the balloon at 50 mm Hg ICP. A significant decrease in ML flow occurred bilaterally at 70 mm Hg ICP. Conduction time was increased significantly between the right VPL and cortex at a pressure of 50 mm Hg. The amplitude of the cortical response was significantly reduced at 30 mm Hg on the right side and 50 mm Hg on the left. Aniscoria occurred at 50 mm Hg ICP and the pupils became dilated at 70 mm Hg. The SEP was possibly more sensitive than the pupillary reactions as an indication of tentorial herniation in these experiments.
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Aoyagi N, Masuzawa H, Sano K, Kihira M, Kobayashi S (1982) [Compliance of Brain, Part 2. Approach from the local elastic and viscous moduli]. No To Shinkei 34: 509–516
Branston NM, Ladds A, Symon L, Wang A-D (1984) Comparison of the effects of ischaemia on early components of the somatosensory evoked potential in brain stem, thalamus and cerebral cortex. J Cereb Blood Flow Metabol 4: 68–81
Branston NM, Symon L (1981) Recording evoked potentials and blood flow from the same electrode in the monkey. J Physiol 312: 26–27
Brock M, Beck J, Markakis E, Dietz H (1972) Intracranial pressure gradients associated with experimental cerebral embolism. Stroke 3: 123–130
Bruce PA, Langfitt TW, Miller JD, Schutz H, Vapalahti MP, Stanek K, Goldberg HI (1973) Regional cerebral blood flow, intracranial pressure and brain metabolism in comatose patients. J Neurosurg 38: 131–144
Coyer PE, Simeone FA, Michele JJ (1988) Extended latency of the cortical component of the somatosensory-evoked potential accompanying moderate increases in cerebral blood flow during systemic hypoxia in cats. Brain Res 441: 145–152
Dorsch NWC, Stephens RJ, Symon L (1971) An intracranial pressure transducer. Biomedical Engineering 6: 452–457
Goodman SJ, Becker DP (1973) Vascular pathology of the brain stem due to experimentally increased intracranial pressure; changes noted in the micro- and macrocirculation. J Neurosurg 39: 601–609
Greenberg RP, Stablein DM, Becker DP (1981) Non invasive localization of brain stem lesion in the cat with multimodality evoked potentials. J Neurosurg 54: 740–750
Grubb RL, Raichle ME, Phelps ME, Ratcheson RA (1975) Effects of increased intracranial pressure on cerebral blood volume, blood flow and oxygen utilization in monkeys. J Neurosurg 43: 385–398
Hassler O (1967) Arterial pattern of human brain stem. Normal appearance and deformation in expanding supratentorial conditions. Neurology 17: 368–375
Hatashita S, Hoff JT (1986) Cortical tissue pressure gradients in early ischaemic brain edema. J Cereb Blood Flow Metabol 6: 1–7
Hekmatpanah J (1970) Cerebral circulation and perfusion in experimental increased intracranial pressure. J Neurosurg 32: 21–29
Jennett WB, Stern WE (1960) Tentorial herniation, the midbrain and the pupil. Experimental studies in brain compression. J Neurosurg 17: 598–609
Johnston IH, Rowan JO (1974) Raised intracranial pressure and cerebral blood flow. 4. Intracranial pressure gradients and regional cerebral blood flow. J Neurol Neurosurg Psychiatry 37: 585–592
Johnston IH, Rowan JO, Harper AM, Jennett WB (1972) Raised intracranial pressure and cerebral blood flow. Cisterna magna infusion in primates. J Neurol Neurosurg Psychiatry 35: 285–296
Johnston IH, Rowan JO, Harper AM, Jennett WB (1973) Raised intracranial pressure and cerebral blood flow. II. Supratentorial and infratentorial mass lesions in primates. J Neurol Neurosurg Psychiatry 36: 161–170
Kaufmann GE, Clark K (1970) Continuous simultaneous monitoring of intraventricular and cervical subarachnoid cerebrospinal fluid pressure to indicate development of cerebral or tonsillar herniation. J Neurosurg 33: 145–150
Koehler RC, Backofen JE, McPherson RW, Jones Jr MD, Rogers MC, Traystman RJ (1989) Cerebral blood flow and evoked potentials during Cushing response in sheep. Am J Physiol 256: 779–788
Langfitt TW, Kassell NF, Weinstein JD (1965) Cerebral blood flow with intracranial hypertension. Neurology 15: 761–773
Langfitt TW, Weinstein JD, Kassell NF, Gagliardi LJ (1964) Transmission of increased intracranial pressure. II. Within the supratentorial space. J Neurosurg 21: 989–997
Langfitt TW, Weinstein JD, Kassell NF; Simeone FA (1964) Transmission of increased intracranial pressure. I. Within the craniospinal axis. J Neurosurg 21: 989–997
Marshall LF, Welsh F, Durity F, Lounsbury R, Graham DI, Langfitt TW (1975) Experimental cerebral oligemia and ischaemia produced by intracranial hypertension. Part 3: Brain energy metabolism. J Neurosurg 43: 323–328
Miller JD, Stanek AE, Langfitt TW (1972) Concepts of cerebral perfusion pressure in vascular compression during intracranial hypertension. Cerebral blood flow. In: Meyer JSet al. (eds) Prog Brain Res, vol 35. Elsevier Publ Co, Amsterdam London New York, pp 411–432
Miller JD, Stanek AE, Langfitt TW (1973) Cerebral blood flow regulation during experimental brain compression. J Neurosurg 39: 186–196
Nagao S, Sunami N, Tsutsui T, Honma Y, Momma F, Nishiura T, Nishimoto A (1984) Acute intracranial hypertension and brain stem blood flow. An experimental study. J Neurosurg 60: 566–571
Nakatani S, Ommaya AK (1972) A critical rate of cerebral compression. In: Brock Met al (eds) Intracranial pressure. Springer, Berlin Heidelberg New York, pp 144–148
Narayan RK, Greenberg RP, Miller JD, Enas GG, Choi SC, Kishore PR, Selhorst JB, Lutz HA, Becker DP (1981) Improved confidence of outcome prediction in severe head injury. A comparative analysis of the clinical examination, multimodality evoked potentials, CT scanning and intracranial pressure. J Neurosurg 54: 751–762
O'Brien MD, Waltz AG (1973) Intracranial pressure gradients caused by experimental cerebral ischaemia and edema. Stroke 4: 694–698
Osborn AG (1977) Diagnosis of descending transtentorial herniation by cranial computed tomography. Radiol 123: 93–96
Sundbarg S, Nornes H (1972) Simultaneous recording of the epidural and ventricular fluid pressure. In: Brock Met al (eds) Intracranial pressure. Springer, Berlin Heidelberg New York, pp 46–50
Sutton LN, Cho BK, Jaggi J, Joseph PM, Bruce DA (1986) Effects of hydrocephalus and increased intracranial pressure on auditory and somatosensory evoked responses. Neurosurgery 18: 756–761
Symon L, Pasztor E, Branston NM, Dorsch NWC (1974) The effect of supratentorial space-occupying lesions on regional intracranial pressure and local cerebral blood flow: An experimental study on baboons. J Neurol Neurosurg Psychiatry 37: 617–626
Takaya M, Moritake K, Konishi T, Suwa H, Hirai O, Handa H (1987) [Experimental study on evoked potentials in predicting the reversibility of brain function following tentorial herniation.] No Shinkei Geka 15: 743–749
Thompson RK, Malina S (1959) Dynamic axial brain stem distortion as a mechanism explaining the cardio-respiratory changes in increased intracranial pressure. J Neurosurg 16: 664–675
Weaver DD, Winn HR, Jane DA (1982) Differential intracranial pressure in patients with unilateral mass lesions. J Neurosurg 16: 660–665
Weinstein JD, Langfitt TW, Bruno L, Zaren HA, Jackson JL (1968) Experimental study of patterns of brain distortion and ischaemia produced by an intracranial mass. J Neurosurg 28: 513–521
Wolff HG, Forbes HS (1928) The cerebral circulation. V. Observations of the pial circulation during changes in intracranial pressure. Arch Neurol Psychiat (Chic) 20: 1035–1047
Yoneda S, Goto H, Matsuda M, Tsuda F, Handa H (1979) Increased intracranial pressure and tentorial shear strain. Neurol Med Chir (Tokyo) 19: 695–702
Zierski J (1987) Blood flow in brain structures during increased ICP. Acta Neurochir (Wien) [Suppl] 40: 95–116
Zwetnow NN (1970) Effects of increased cerebrospinal fluid pressure on the blood flow and on the energy metabolism of the brain. An experimental study. Acta Physiol Scand [Suppl 339] 79: 1–31
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Nitta, M., Tsutsui, T., Ueda, Y. et al. The effects of an extradural expanding lesion on regional intracranial pressure, blood flow, somatosensory conduction and brain herniation: an experimental study in baboons. Acta neurochir 104, 30–37 (1990). https://doi.org/10.1007/BF01842890
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DOI: https://doi.org/10.1007/BF01842890