SpringerLink
Log in

Erhöhter intrakranieller Druck

  • Chapter
Die Intensivmedizin

  • 148 Accesses

Zusammenfassung

Der Inhalt des Neurokrniums besteht uas weichen Hirngewebe, den bindegewebigen Hirnhäuten und -gefäßen (kompressibles Kompartiment) sowie den Flüssigkeiten Liquor und Blut (inkompressibles Kompartiment). Bei einem Gesamtvolumen von ca. 1500 ml beträgt der Anteil der Hirnsubstanz etwa 1100–1200 ml. Blut- und Liquorvolumen tragen je etwa 150 ml bei. Beim Blutvolumen überwiegt mit 2/3 der venöse Anteil. Der Liquor verteilt sich im extra- und intraventrikulären Raum, wobei sich ersterer von intrakraniell kaudalwäts in den spinalen Subarachnoidalraum forsetzt. Da sich der knöcherne Hirnschädel nach Schluss der Nähte nicht ausdehnen kannm steht die sen Volumina ein begrenzter Raum (V>gesamt) zur Verfügung. Tritt eine vierte Komponente (dV>Raumforderung) hinzu, muss diese durch Ausgleichdbewegugugen des inkiompressiblen Kompartiments aufgewogen werden.

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

Access this chapter

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 54.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Similar content being viewed by others

Literatur

  1. Akioka T, Ota K, Matsumoto A, et al. (1976) The effect ofTHAM on acute intracranial hypertension. An experimental and clinical study. In: Behs JWF, Bosch DA, Brock M (eds) Intracranial pressure Ill. Springer, Berlin Heidelberg New York, pp 219–233

    Chapter  Google Scholar 

  2. Arbeitsgemeinschaft»Intensivmedizin und Neurotraumatologie* der Deutschen Gesellschaft für Neurochirurgie, Arbeitskreis »Neuroanästhesie* der Deutschen Gesellschaft für Anaesthesiologie und Intensivmedizin, »Sektion Rettungswesen* der DIVI (Deutsche Interdisziplinäre Vereinigung für Intensivmedizin) (1996) Mitt Dtsch Ges Neurochir 6: 6–11

    Google Scholar 

  3. Asgeirsson B, Grände P-O, Nordström C-H (1995) The Lund concept of post traumatic brain edema therapy. Acta Anaesth Scand 39: 112–114

    Article  Google Scholar 

  4. Baethmann A, Jantzen J-P, PiekJ, Prange H, Unterberg AW (1997) Physiologie und Pathophysiologie des intrakraniellen Druckes. Zentralbl Neurochir 58: 29–31

    CAS  Google Scholar 

  5. Barry KG, Berman AR (1961) Mannitol Infusion. Part III.The acute effect of the intravenous infusion of mannitol on blood and plasma volume. N Engl J Med 264: 1085–1088

    Google Scholar 

  6. Bullock R, Chesnut RM, Clifton G, Ghajar J, Marion DW, Narayan RK, Newell DW, Pitts LH, Rosner Mi, Wilberger JE (2000) Management and prognosis of severetraumatic brain injury. Part 1:Guidelinesforthe management of severe traumatic brain injury. J Neurotrauma 17: 449–553

    Google Scholar 

  7. Clifton GL, Miller RE, Choi SC, Levin HS et al. (2001) Lack of effect on induction of hypothermia after acute brain injury. N Eng J Med 344: 556–563

    Article  CAS  Google Scholar 

  8. Darby JM, Yonas H, Marion DW, et al. (1988) Local *inverse steal* induced by hyperventilation in head injury. Neurosurgery 23: 84–88

    Article  PubMed  CAS  Google Scholar 

  9. Eisenberg HM, Frankowski RF, Contant CF (1988) High-dose barbiturates control elevated intracranial pressure in patients with severe head injury.) Neurosurg 69: 15–23

    CAS  Google Scholar 

  10. Gaab M, Knoblich 0E, Spohr A, et al. (1980) The effect ofTHAM on ICP, EEG, and tissue edema parameters in experimental and clinical brain edema. In: Shulman K, Mamarov A, Miller JD et al. (eds) Intracranial pressure IV. Springer, Berlin Heidelberg New York, pp 664–668

    Google Scholar 

  11. Gaab MR, Rittierodt M, Lorenz M, Heissler HE (1990) Traumatic brain swelling and operative decompression: a prospective investigation. Acta Neurochir (Suppl) 51: 326–328

    CAS  Google Scholar 

  12. James HE (1980) Methodology for the control of intracranial pressure with hypertonic mannitol. Acta Neurochir 51: 161–172

    Article  PubMed  CAS  Google Scholar 

  13. Kiening KL, Sarrafzadeh AS, BardtTF Härtl R, Unterberg AW, Lanksch WR (1997) Effect ofTromethamine (THAM) on brain tissue p02, pCO2 and pH in severely head injured patients. Acta Neurochir (Suppl) 70: 188–190

    CAS  Google Scholar 

  14. Kiening KL, Unterberg AW, BardtTF, Schneider GH, Lanksch WR (1996) Monitoring of cerebral oxygenation in patients with severe head injuries: brain tissue p0* vs. jugular vein oxygen saturation.) Neurosurg 85: 751–757

    CAS  Google Scholar 

  15. Kleist-Welch Guerra W, Gaab MR, Dietz H, Müller JU, Piek J, Fritsch MJ (1999) Surgical decompression for traumatic brain swelling: indications and results.) Neurosurg 90: 187–196

    Google Scholar 

  16. Lundberg N (1960) Continuous recording and control of ventricular fluid pressure in neurosurgical practice. Acta Psychiatr Neurol Scand 36: 1–193

    CAS  Google Scholar 

  17. Lyons MK, Meyer FB (1990) Cerebrospinal fluid physiology and the management of increased intracranial pressure. Mayo Clin Proc 65: 684–707

    Article  PubMed  CAS  Google Scholar 

  18. Maas Al, Dearden M,Teasdale GM et al. (1997) EBIC-guidelinesfor management of severe head injury in adults. European Brain Injury Consortium. Acta Neurochir 139: 286–294

    Google Scholar 

  19. Marion DW, Penrod LE, Kelsey SF et al. (1997) Treatment of traumatic brain injury with moderate hypothermia. N Engl J Med 336: 540–546

    Article  PubMed  CAS  Google Scholar 

  20. Marmarou A, Barzo P, Fatouros Petal. (1997) Traumatic brain swelling in head injured patients: brain edema or vascular engorgement? Acta Neurochir (Suppl) 70: 68–70

    CAS  Google Scholar 

  21. Maset AL, Marmarou A, Ward JD et al. (1987) Pressure volume index in head injury.) Neurosurg 67: 832–840

    CAS  Google Scholar 

  22. McGraw CP, Howard JP (1983) The effect of mannitol on increased intracranial pressure. Neurosurgery 13: 269–271

    Article  PubMed  CAS  Google Scholar 

  23. Metz C, Holzschuh M, Bein T (1996) Moderate hypothermia in patients with severe head injury: Cerebral and extracerebral effects. J Neurosurg 85: 533–541

    Google Scholar 

  24. Miller JD, Becker DP, Ward JD et al. (1977) Significance of intracranial hypertension in severe head injury.) Neurosurg 47: 503–516

    CAS  Google Scholar 

  25. Muizelaar JP, Marmarou A, Ward JD et al. (1991) Adverse effects of prolonged hyperventilation in patients with severe head injury: A randomized clinical trail. J Neurosurg 75: 731–739

    Google Scholar 

  26. Rosner MJ, Coley IB (1986) Cerebral perfusion pressure, intracranial pressure, and head elevation. J Neurosurg 65: 636–641

    Article  PubMed  CAS  Google Scholar 

  27. Rosner MJ, Rosner SD,Johnson AH (1995) Cerebral perfusion pressure: management protocol and clinical results. J Neurosurg 83: 949–962

    CAS  Google Scholar 

  28. Schneider GH, von Helden GH, Franke R, Lanksch WR, Unterberg AW (1993) Influence of body position on jugular venous oxygen saturation, intracranial pressure and cerebral perfusion pressure. Acta Neurochir (Suppl) 59: 107–112

    CAS  Google Scholar 

  29. Unterberg AW (1999) Hirnödem and intrakranielle Drucksteigerung. In: Piek J, Unterberg AW (Hrsg) Grundlagen neurochirurgischer Intensivmedizin. Zuckschwerdt, München 201–224

    Google Scholar 

  30. Ward JD, Becker DP, Miller JD, et al. (1985) Failure of prophylactic barbiturate coma in the treatment of severe head injury. J Neurosurg 62: 383–388

    Article  PubMed  CAS  Google Scholar 

Download references

Authors
  1. A. W. Unterberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. O. W. Sakowitz
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Am Weinberge 18, 37120, Bovenden, Deutschland

    H. Burchardi

  2. Klinik für Anästhesiologie und Intensivmedizin, Universitätskliniken des Saarlandes, Klinikum-Gebäude 56, 66421, Homburg/Saar, Deutschland

    R. Larsen

  3. Städtisches Krankenhaus Hildesheim, Weinberg 1, 31134, Hildesheim, Deutschland

    H.-P. Schuster

  4. Division des Soins Intensifs, Chirurgicaux, Hôpital Cantonal Universitaire, Rue Micheli-du-Crest 24, 1211, Genève 14, Schweiz

    P. M. Suter

Rights and permissions

Reprints and permissions

Copyright information

© 2004 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Unterberg, A.W., Sakowitz, O.W. (2004). Erhöhter intrakranieller Druck. In: Burchardi, H., Larsen, R., Schuster, HP., Suter, P.M. (eds) Die Intensivmedizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-06654-6_40

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-06654-6_40

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-06655-3

  • Online ISBN: 978-3-662-06654-6

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation