Erroneous intracranial pressure measurements from simultaneous pressure monitoring and ventricular drainage catheters

The objective of this report is to highlight the potential for false pressure measurements from systems that combine intracranial pressure (ICP) measurement and ventricular drainage. If the ports of the drain become blocked to the extent that they present a high resistance to cerebrospinal fluid flow, then a significant pressure gradient between the inside and outside of the catheter may be established. Thus, any intracatheter transducer will faithfully record a pressure much lower than true ICP. This holds true for catheter-tip transducers when the transducer lies inside the catheter. In the absence of flow, however, pressures will equalize; therefore, accurate measurements may be taken if the drain is temporarily closed. We model this situation and provide simulations of expected measurements in such situations; these compare well to observed clinical readings.</p

Decompressive craniectomy for acute disseminated encephalomyelitis.

Background: Acute disseminated encephalomyelitis (ADEM) is a rare, acute demyelinating condition. Although it usually presents in an acute or subacute manner over days, its clinical course may be rapid with symptoms and signs of severe intracerebral mass effect secondary to cerebral oedema. Methods: Case report and literature review.Results: We report a case of a patient presenting with a hyperacute course manifested by rapid loss of consciousness and focal neurological signs. Management with emergency hemicraniectomy and steroids resulted in rapid neurological improvement and minimal long-term deficit. Conclusions: We believe that only surgical decompression is likely to be life saving in similar cases of hyperacute cerebral oedema due to ADEM. The wide decompression performed was concordant with that indicated for traumatic brain swelling. Such aggressive management is vindicated by the rapid recovery shown by our patient within days of surgery and the finding of minimal neurological sequelae at 3 months. <br/

No evidence of a common DNA variant profile specific to world class endurance athletes

10.1371/journal.pone.0147330PLoS ONE111e014733