Monitoring of Cerebral Blood Flow and Metabolism in Intensive Care

1. Front Matter

   Pages i-viii

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2. Physiology and Pathophysiology of Cerebral Blood Flow and Metabolism

   1. Front Matter

      Pages 1-1

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   2. Regulation of Cerebral Blood Flow — A Brief Review

      • M. Wahl, L. Schilling

      Pages 3-10

   3. Relationship of Cerebral Blood Flow Disturbances with Brain Oedema Formation

      • Reinhart Murr, S. Berger, L. Schürer, O. Kempski, F. Staub, A. Baethmann

      Pages 11-17

   4. Measurement of Vascular Reactivity in Head Injured Patients

      • A. Marmarou, K. Bandoh, M. Yoshihara, O. Tsuji

      Pages 18-21

3. Intermittent Measurements of Cerebral Blood Flow and Metabolism in Intensive Care

   1. Front Matter

      Pages 23-23

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   2. Measurements of Cerebral Blood Flow and Metabolism in Severe Head Injury Using the Kety-Schmidt Technique

      • Claudia Robertson

      Pages 25-27

   3. Xenon 133 — CBF Measurements in Severe Head Injury and Subarachnoid Haemorrhage

      • J. Meixensberger

      Pages 28-33

   4. Evaluation of Regional Cerebral Blood Flow in Acute Head Injury by Stable Xenon-Enhanced Computerized Tomography

      • G. J. Bouma, J. P. Muizelaar

      Pages 34-40

4. Continuous Monitoring of Cerebral Blood Flow and Metabolism in Intensive Care

   1. Front Matter

      Pages 41-41

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   2. Thermodiffusion

      1. Cerebral Blood Flow (CBF) Monitoring in Intensive Care by Thermal Diffusion

         • L. P. Carter, M. E. Weinand, K. J. Oommen

         Pages 43-46

      2. Monitoring of Regional Cerebral Blood Flow (CBF) in Acute Head Injury by Thermal Diffusion

         • M. L. Schröder, J. P. Muizelaar

         Pages 47-49

   3. Tissue pO2

      1. Monitoring Cerebral Oxygenation: Experimental Studies and Preliminary Clinical Results of Continuous Monitoring of Cerebrospinal Fluid and Brain Tissue Oxygen Tension

         • A. I. R. Maas, W. Fleckenstein, D. A. de Jong, H. van Santbrink

         Pages 50-57

      2. Studies of Tissue PO2 in Normal and Pathological Human Brain Cortex

         • J. Meixensberger, J. Dings, H. Kuhnigk, K. Roosen

         Pages 58-63

   4. Laser-Doppler Flowmetry

      1. Applicability of Laser-Doppler Flowmetry for Cerebral Blood Flow Monitoring in Neurological Intensive Care

         • R. L. Haberl, A. Villringer, U. Dirnagl

         Pages 64-68

      2. Assessment of Cerebral Haemodynamics in Comatose Patients by Laser Doppler Flowmetry — Preliminary Observations

         • R. Steinmeier, I. Bondar, C. Bauhuf

         Pages 69-73

   5. Near Infrared Spectroscopy

      1. Measurement of Adult Cerebral Haemodynamics Using Near Infrared Spectroscopy

         • C. E. Elwell, H. Owen-Reece, M. Cope, J. S. Wyatt, A. D. Edwards, D. T. Delpy et al.

         Pages 74-80

   6. Transcranial Doppler Sonography

      1. Transcranial Doppler-Sonography in Severe Head Injury

         • K.-H. Chan, N. M. Dearden, J. D. Miller

         Pages 81-85

   7. Jugular-Venous Oximetry

      1. Cerebral Oxygenation

         • J. Cruz

         Pages 86-90

      2. Technical Considerations in Continuous Jugular Venous Oxygen Saturation Measurement

         • N. Mark Dearden, S. Midgley

         Pages 91-97

Until recently, monitoring of cerebral blood flow and metabolism was an unattained goal. Determination of cerebral blood flow was limited to intermittent measurements and particularly difficult to perform in critically ill patients. Meanwhile there are techniques available, however, to monitor cerebral blood flow and cerebral oxygenation, both globally and regionally. Therefore we thought it worthwhile to discuss these new continuous techniques and to compare them with well-known techniques which discontinuously measure CBF. For that purpose, an international workshop with some leading experts in the field was held in October 1992 in Berlin. The workshop consisted of about 20 lectures, either reviews on a special topic, or latest results. These contributions were given by invitation and were extensively discussed. Unfortunately it is impossible to reproduce the discussions. On the other hand, all speakers delivered a manuscript promptly after the meeting so that we were able to edit them within a short time. Since monitoring of cerebral blood flow in intensive care is a rapidly growing and changing topic, the written contributions should be quickly available. Authors, editors and publishers have tried to come close to this ideal. As editors we would like to thank the authors and the publishers who enabled us to come out with this volume of the proceedings as early as possible.

• Trauma
• blood
• brain
• brain injury
• care
• cerebral ischemia
• cortex
• head
• head injury
• intensive care
• intracranial pressure
• pathophysiology
• physiology
• spectroscopy
• tomography

• Abteilung für Neurochirurgie, Universitätsklinikum Rudolf Virchow, Freie Universität Berlin, Federal Republic of Germany

  Andreas W. Unterberg, Gerd-Helge Schneider, Wolfgang R. Lanksch

Policies and ethics