Skip to main content
SpringerLink
Log in

The effects of an extradural expanding lesion on regional intracranial pressure, blood flow, somatosensory conduction and brain herniation: an experimental study in baboons

  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. 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

    PubMed  Google Scholar 

  2. 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

    Google Scholar 

  3. Branston NM, Symon L (1981) Recording evoked potentials and blood flow from the same electrode in the monkey. J Physiol 312: 26–27

    Google Scholar 

  4. Brock M, Beck J, Markakis E, Dietz H (1972) Intracranial pressure gradients associated with experimental cerebral embolism. Stroke 3: 123–130

    PubMed  Google Scholar 

  5. 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

    PubMed  Google Scholar 

  6. 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

    PubMed  Google Scholar 

  7. Dorsch NWC, Stephens RJ, Symon L (1971) An intracranial pressure transducer. Biomedical Engineering 6: 452–457

    PubMed  Google Scholar 

  8. 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

    PubMed  Google Scholar 

  9. 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

    PubMed  Google Scholar 

  10. 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

    PubMed  Google Scholar 

  11. Hassler O (1967) Arterial pattern of human brain stem. Normal appearance and deformation in expanding supratentorial conditions. Neurology 17: 368–375

    PubMed  Google Scholar 

  12. Hatashita S, Hoff JT (1986) Cortical tissue pressure gradients in early ischaemic brain edema. J Cereb Blood Flow Metabol 6: 1–7

    Google Scholar 

  13. Hekmatpanah J (1970) Cerebral circulation and perfusion in experimental increased intracranial pressure. J Neurosurg 32: 21–29

    PubMed  Google Scholar 

  14. Jennett WB, Stern WE (1960) Tentorial herniation, the midbrain and the pupil. Experimental studies in brain compression. J Neurosurg 17: 598–609

    PubMed  Google Scholar 

  15. 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

    PubMed  Google Scholar 

  16. 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

    PubMed  Google Scholar 

  17. 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

    PubMed  Google Scholar 

  18. 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

    PubMed  Google Scholar 

  19. 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

    Google Scholar 

  20. Langfitt TW, Kassell NF, Weinstein JD (1965) Cerebral blood flow with intracranial hypertension. Neurology 15: 761–773

    PubMed  Google Scholar 

  21. Langfitt TW, Weinstein JD, Kassell NF, Gagliardi LJ (1964) Transmission of increased intracranial pressure. II. Within the supratentorial space. J Neurosurg 21: 989–997

    PubMed  Google Scholar 

  22. Langfitt TW, Weinstein JD, Kassell NF; Simeone FA (1964) Transmission of increased intracranial pressure. I. Within the craniospinal axis. J Neurosurg 21: 989–997

    PubMed  Google Scholar 

  23. 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

    PubMed  Google Scholar 

  24. 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

    Google Scholar 

  25. Miller JD, Stanek AE, Langfitt TW (1973) Cerebral blood flow regulation during experimental brain compression. J Neurosurg 39: 186–196

    PubMed  Google Scholar 

  26. 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

    PubMed  Google Scholar 

  27. 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

    Google Scholar 

  28. 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

    PubMed  Google Scholar 

  29. O'Brien MD, Waltz AG (1973) Intracranial pressure gradients caused by experimental cerebral ischaemia and edema. Stroke 4: 694–698

    PubMed  Google Scholar 

  30. Osborn AG (1977) Diagnosis of descending transtentorial herniation by cranial computed tomography. Radiol 123: 93–96

    Google Scholar 

  31. 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

    Google Scholar 

  32. 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

    PubMed  Google Scholar 

  33. 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

    PubMed  Google Scholar 

  34. 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

    PubMed  Google Scholar 

  35. 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

    PubMed  Google Scholar 

  36. Weaver DD, Winn HR, Jane DA (1982) Differential intracranial pressure in patients with unilateral mass lesions. J Neurosurg 16: 660–665

    Google Scholar 

  37. 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

    PubMed  Google Scholar 

  38. 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

    Google Scholar 

  39. 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

    Google Scholar 

  40. Zierski J (1987) Blood flow in brain structures during increased ICP. Acta Neurochir (Wien) [Suppl] 40: 95–116

    Google Scholar 

  41. 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

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Gough-Cooper Department of Neurological Surgery, Institute of Neurology, National Hospital for Nervous Disease, London, UK

    L. Symon

  2. Department of Neurosurgery, Nagoya City University Medical School, Mizuho-ku, 467, Nagoya, Japan

    M. Nitta

  3. Department of Neurological Surgery, Okayama University Medical School, 2-5-1 Shikata-Cho, 700, Okayama, Japan

    T. Tsutsui

Authors
  1. M. Nitta
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. T. Tsutsui
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Y. Ueda
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. Ladds
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. L. Symon
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

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

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01842890

Keywords

Search

Navigation