Neurology India
menu-bar5 Open access journal indexed with Index Medicus
  Users online: 6074  
 Home | Login 
About Editorial board Articlesmenu-bullet NSI Publicationsmenu-bullet Search Instructions Online Submission Subscribe Videos Etcetera Contact
  Navigate Here 
 »   Next article
 »   Previous article
 »   Table of Contents

 Resource Links
 »   Similar in PUBMED
 »  Search Pubmed for
 »  Search in Google Scholar for
 »Related articles
 »   Citation Manager
 »   Access Statistics
 »   Reader Comments
 »   Email Alert *
 »   Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded318    
    Comments [Add]    
    Cited by others 6    

Recommend this journal


Year : 2004  |  Volume : 52  |  Issue : 1  |  Page : 67--71

Cerebral perfusion pressure management of severe diffuse head injury: Effect on brain compliance and intracranial pressure

1 Departments of Neurosurgery, National Institute of Mental Health and Neurosciences, Bangalore, India
2 Departments of Neuroanesthesia, National Institute of Mental Health and Neurosciences, Bangalore, India

Correspondence Address:
S Pillai
Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Hosur Road, Bangalore - 560029
Login to access the Email id

Source of Support: None, Conflict of Interest: None

PMID: 15069242

Rights and PermissionsRights and Permissions

Background: Cerebral perfusion pressure management (CPPM) is an accepted modality of treatment of severe diffuse head injury (SDHI). However, CPPM has the potential to cause transcapillary exudation in the presence of a disrupted blood brain barrier and can lead to further increase of intracranial pressure (ICP) and worsening of compliance. Aims: This study attempts to evaluate the effect of both transient and prolonged changes in cerebral perfusion pressure (CPP) on ICP and cerebral compliance as measured by the Pressure Volume Index (PVI), and to correlate changes in PVI with outcome at 12 months using the Glasgow Outcome Score. Settings and Design: Prospective study in a neurosurgical ICU. Material and Methods: Twenty-seven SDHI patients managed using standard protocol to maintain CPP above 70 mmHg. Mean arterial pressure (MAP), ICP and CPP were monitored every half-hour. Daily monitoring of the PVI and ICP was done before, and after the induced elevation of MAP using IV Dopamine infusion. The relationship between CPP, MAP, ICP, PVI and outcome was evaluated. Statistical analysis used: The paired and independent samples T-test, and the Pearson correlation coefficient. Results: CPPM rarely leads to progressive rise in ICP. Maintaining CPP above 70mmHg does not influence ICP or PVI. Transient elevations in CPP above 70mmHg may produce a small rise in ICP. Trend of change in PVI influenced outcome despite similar ICP and CPP. Conclusion: Elevating the CPP above 70mmHg does not either reduce the ICP or worsen the compliance. Monitoring changes in compliance should form an integral part of CPPM.


Print this article     Email this article

Online since 20th March '04
Published by Wolters Kluwer - Medknow