caa a22 4500 477140076 CHVBK 20180405111730.0 cr unu---uuuuu 170330e19971201xx s 000 0 eng 10.1007/BF01105899 doi (NATIONALLICENCE)springer-10.1007/BF01105899 Short-term lack of cerebral perfusion with good outcome. Advantages of early intracranial pressure monitoring [Elektronische Daten] [Frank Diesner, Dag Moskopp, Christoph Schul, Hansdetlef Wassmann] A 21-year-old man was injured by a tailboard of a truck. He suffered a severe head injury with bilateral depressed skull fractures necessitating surgical decompression. On admission to the hospital the patient showed bending to pain stimuli (Glasgow Coma Score 5). Anisocoria was noticed from the beginning. Initial intracranial pressure (ICP), measured 3 hours after injury, was 30 mm Hg, and the cerebral perfusion pressure (CPP) was 70 mm Hg. During surgical elevation of the skull fracture on the right side an unexplainable rise of ICP to values of 100 mm Hg occurred, which corresponded to the mean arterial blood pressure (MAP). At the same time both pupils were dilated and fixed indicating a lack of cerebral perfusion. Due to immediate trephination of the opposite side, the ICP was lowered to values below 20 mm Hg, and sufficient cerebral perfusion (above 50 mm Hg) was regained. The patient showed a good recovery and was transferred to a rehabilitation center 5 weeks after injury. This case report emphasizes the importance of early and continuous intracranial pressure monitoring for adequate therapy in neurosurgical emergencies. Walter de Gruyter & Co., 1997 Bilateral depressed skull fracture nationallicence ICP-monitoring nationallicence severe head injury nationallicence traumatic brain swelling nationallicence Diesner Frank Neurochirurgische Klinik, WW Universität Münster, Albert-Schweitzer-Str. 33, D-48149, Münster, Germany aut Moskopp Dag Neurochirurgische Klinik, WW Universität Münster, Albert-Schweitzer-Str. 33, D-48149, Münster, Germany aut Schul Christoph Neurochirurgische Klinik, WW Universität Münster, Albert-Schweitzer-Str. 33, D-48149, Münster, Germany aut Wassmann Hansdetlef Neurochirurgische Klinik, WW Universität Münster, Albert-Schweitzer-Str. 33, D-48149, Münster, Germany aut Neurosurgical Review Springer-Verlag 20/4(1997-12-01), 274-277 0344-5607 20:4<274 1997 20 10143 https://doi.org/10.1007/BF01105899 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF01105899 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Diesner Frank Neurochirurgische Klinik, WW Universität Münster, Albert-Schweitzer-Str. 33, D-48149, Münster, Germany aut NATIONALLICENCE 700 1- Moskopp Dag Neurochirurgische Klinik, WW Universität Münster, Albert-Schweitzer-Str. 33, D-48149, Münster, Germany aut NATIONALLICENCE 700 1- Schul Christoph Neurochirurgische Klinik, WW Universität Münster, Albert-Schweitzer-Str. 33, D-48149, Münster, Germany aut NATIONALLICENCE 700 1- Wassmann Hansdetlef Neurochirurgische Klinik, WW Universität Münster, Albert-Schweitzer-Str. 33, D-48149, Münster, Germany aut NATIONALLICENCE 773 0- Neurosurgical Review Springer-Verlag 20/4(1997-12-01), 274-277 0344-5607 20:4<274 1997 20 10143 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer