The pioneering work by Pierre Janny and Nils Lundberg added a new tool to the investigative armamentarium of the neurosurgeon: continuous monitor ing of intracranial pressure (ICP). A small group of basic and clinical sci entists recognized the importance of this method and in 1972 an International Symposium was organized by Mario Brock in Hannover, Germany. The workers "of the first hour" had high expectations and thought that the problem of intracranial hypertension could finally be dealt with. The Symposium con tinued to grow during subsequent meetings in Lund (1974), Groningen (1976) and Williamsburg (1979). However, the advent of the modern imaging tech niques of CT and MRI have dramatically changed the scene in clinical neurology and neurosurgery. These new methods as well as other monitoring techniques have put ICP in its proper place as just one of the many aspects, albeit an important one, in the management of patients with intracranial space-occupying lesions. The symposia in Tokyo (1982), Glasgow (1985) and Ann Arbor (1988) confirmed the steady interest in ICP recording, both as a research tool and as a clinical method. and yielded many new developments in the field of ICP. This book comprises the proceedings of the Eighth International Symposium on Intracranial Pressure that was held in Rotterdam, The Netherlands, from June 16th to 20th, 1991.

Session I: Methodology and Mass Lesions

Methodology
Clinical Evaluation of the Camino Ventricular Bolt Pressure Monitoring System
A Clinical Evaluation of an Intraparenchymal Intracranial Pressure Transducer
Continuous Monitoring of Supratentorial Cerebral Tissue Pressure in Neurosurgical Routine. Experience with 125 Patients
Continuous Monitoring of Cerebral Tissue Pressure After Elective Posterior Fossa Surgery
A Fiberoptic Device Suitable for Subdural Pressure Measurement
Anterior Fontanelle Pressure Monitoring in Infants
Anterior Fontanelle Pressure Values in Normal Young Children of Various Ages
A New Way to Monitor External Ventricular Drainage
Post Traumatic Cerebrospinal Fluid Infections in the Traumatic Coma Data Bank: The Influence of the Type and Management of ICP Monitors
Intracranial Distension in Neurosurgical Pathology
Data Analysis
On-Line Acquisition and Analysis of ICP and Physiologic Data in the Neurosurgical Intensive Care Unit
Continuous Monitoring and Recording of Cerebral Perfusion Pressure
Attempts to Continuously Monitor Autoregulation and Compensatory Reserve in Severe Head Injuries
Further Attempts to Anticipate Post-traumatic Intracranial Hypertension by On-line Analysis
Mass Lesions
The Mechanism of Formation of Brain Tumor Cysts
Spontaneous Putaminal Haematoma. Does Post-Operative ICU Management Improve Outcome?
Assessment of Brainstem Distortion Associated with Extraaxial Supratentorial Mass by Magnetic Resonance Imaging
Bilateral Intraparenchymal Pressure in Patients with Unilateral Supratentorial Mass Lesions
Effects of Glycerol on Cerebral Blood Flow and Neural Function in Patients with Intracranial Space Occupying Lesions
Peritumoral Edema and Regional Cerebral Blood Flow in Brain Tumors
Session II: Experimental Aspects
Edema
Compression-induced Brain Edema: Regional Changes of Superoxide Free Radicals in the Development of Vasogenic Edema and Tissue Damage in Intracranial Hypertension
The Effect of Lazaroid on Cerebral Elastance and Edema in a Cryogenic Injury Model
Effects of Corticosteroid and Mannitol on the Early and Developed Stage of Vasogenic Brain Edema Evaluated by Proton Relaxation Behaviour
The Effect of Hypoxia, Hypercapnia, and Hypertension on Brain Edema
Role of Stimulation of Medullary Reticular Formation on Centrally Released Arginine Vasopressin in Cold Induced Edema
Amino-Acids Release in Cerebrospinal Fluid After Injury of Cat Brain with Cold Lesion
Regional Tissue Compliance of Edematous Brain After Cryogenic Injury in Cats
Microautoradiographic Examination of Edema Fluid Distribution in the Cat Brain After Cryogenic Injury
Gray Matter Edema Following Subarachnoid Hemorrhage
Blood-Brain Barrier
Effects of Leukotriene C4 and Acivicin on the Blood-Brain Barrier Permeability of Ischemic Rat Brains: Proof of Existence of Enzymatic Barrier
Temporary Blood Brain Barrier Damage and Continued Edema Formation in Experimental Closed Head Injury in the Rat
Breakdown of the Blood-Brain Barrier to Horseradish Peroxidase After Experimental Post-Traumatic Hypoxic Brain Injury
Delayed Opening of the Blood-Brain Barrier in Direct Infusion Edema Model
Effect of Osmotic Opening of Blood-Brain Barrier on the Learning of Rats
Ischemia
Improved Recovery with 21-Aminosteroid (U74006F) Pretreatment After Incomplete Cerebral Ischemia
Effects of Respiratory Depression on Cytoprotective Effect of the Competitive NMDA Antagonist, D-CPPene
Electrical Impedance, ICP and Histology in Rats with Sagittal Sinus Occlusion
Experimental Study on Cerebral Venous Circulatory Disturbance
Measuring the Degree of Ischemic Change by AVDO2 and EEG
Local Cerebral Blood Flow, Glucose Content and Glucose Utilization in Focal Cerebral Ischemia in Spontaneously Hypertensive Stroke-Prone Rats
Effect of External Decompression on Cerebral Venous System Occlusion
Epidural Pressure and Cerebral Perfusion Pressure in Cerebral Infarction with Massive Brain Swelling
Effects of Prostacyclin Analog (OP-2507) on Experimental Focal Cerebral Ischemia
Hyperthermia
Intracranial Pressures and Fever in the Rat, Rabbit and Cat
Influences of Total Body Hyperthermia by Extracorporeal Circulation on Intracranial Hemodynamics in Dogs
Neurophysiology
Control of ICP by the Medullary Reticular Formation
Analysis of Pyramidal Tract Function in Experimental Intracranial Hypertension by Magnetic Stimulation
Neurophysiological Evidence of Preservation of Brain Stem Function in Experimental Closed Head Injury in the Rat
Panel 1: Methodology and Experimental Aspects
Session III: Cerebrovascular Dynamics I
Cerebral Blood Flow and Metabolism: Experimental
Effect of Increased ICP and Decreased Cerebral Perfusion Pressure on Brain Tissue and Cerebrospinal Fluid Oxygen Tension
The Effect of Hypoxia on Intracranial Pressure and Cerebral Blood Flow
Intracranial Hypotension: A Feline Model and Effects on Cerebral Blood Flow
Change of Cerebral Electrophysiological Activity, Regional Cerebral Blood Flow and Regional Cerebral Blood Volume in Acute Intracranial Hypertension
Local Cerebral Blood Flow Mapping Before and After Removal of Acute Subdural Hematoma in the Rat
The Effects of NMDA Antagonists on Intracranial Pressure In a Model of Acute Subdural Haematoma in the Rat
Intracranial Pressure and Phosphorus-31 Magnetic Resonance Spectroscopy in Cats
Biomechanical Regulation of Cerebral Blood Flow
Cerebral Blood Flow Restoration After Decompressive Craniectomy in Cold Induced Brain Edema
The Metabolic Protection of Hypoxia by Etomidate Evaluated by Magnetic Resonance Spectroscopy
Effect of Torasemide - A New Cl--Transport Inhibitor on Glial Swelling by Lactacidosis and Glutamate
The Effects of Vasopressin on Intracranial Pressure and Cerebrovascular Dynamics in the Rat
Cerebral Blood Flow and Metabolism: Clinical
Cerebral Aerobic Index and Oxygen/Glucose Ratio in Acute Brain Injury
Combined Monitoring of ICP and Cerebrovenous Oxygen Saturation to Estimate Cerebral Blood Flow
Functional Exploration of the Internal Jugular Veins
Blood Pressure and ICP Dynamics in Severe Head Injury: Relation with CBF Autoregulation
Reversibility of Cerebral Circulatory Arrest (CCA) Following Severe Intracranial Hypertension
ICP and Flow Dynamics After Subarachnoid Hemorrhage
Session IV: Cerebrovascular Dynamics II
Transcranial Doppler
Evaluation of Closed Head Injury Patients Using Transcranial Doppler Monitoring
The Significance of Increased Transcranial Doppler Flow Velocity After Severe Brain Injury
A Study of Alterations of Cerebral Circulation Following Head Injury Using Transcranial Doppler Sonography
Impaired Carbon Dioxide Reactivity Predicts Poor Outcome In Severe Head Injury: A Transcranial Doppler Study
Cerebrovascular Reactivity Assessed by Changes in ICP and Transcranial Doppler
Relationship Between Cerebral Perfusion Pressure and Pulsatility Index of Transcranial Doppler Sonogram
Estimation of Cerebral Perfusion Pressure From Transcranial Doppler Sonography in Comatose Patients
Changes in Cerebral Blood Flow During ICP Monitoring
Non-Invasive Monitoring of Intracranial Pressure Gradients by Means of Transcranial Doppler
Wave Form Analysis
Comparison of Methods for ICP Waveform Analysis with Intracranial Hypertension in Head-Injured Patients
Effects of Heart Rate on the Shape of the Intracranial Pressure Wave and Related Parameters
Vascular Mapping of the Intracranial Pulse Wave
Changes of Intracranial Pressure and Pulse Wave Form Induced by Various Mechanical Stresses Upon Intracranial Hemodynamics
Analysis of the Intracranial Pressure Waveform by Means of Spectral Methods
Continuous Analysis of the Intracranial Pressure Waveform as a Method of Autoregulatory Reserve Assessment
Differential Effect of Hypercarbia and Hypertension on Cerebrovascular Pressure Transmission and Craniospinal Compliance
A Simulation Study of Wave Transformation Using a Nonlinear Model of Artery and a Physical Model of Intracranial Vascular Bed
Computer Analysis of Intracranial Pressure Pulsatility and Blood Flow Shape During Intracranial Hypertension
Influence of Intracranial Components on Epidural Pulse Pressure
Systolic Cerebral Blood Inflow (SCBI) as a CBF-Index Estimated with ICP Wave - Change in CBF and SCBI During Mannitol Infusion
Dynamic Response of Subdural Screw Bolt for Intracranial Pressure Measuring
Analysis of Periodic Waveforms of Brain Element Oscillations
Pressure Waves
Cyclic CSF Pressure Waves Causally Relate to Systemic Arterial Blood Pressure
Changes in Jugular Bulb Oxygen Saturation and Associated Changes in Intracranial Pressure
Spontaneous Fluctuations in Cerebral Blood Flow as a Cause of B Waves
Postural Changes
Changes in Cerebral Hemodynamics With Head Elevation In Head-Injured Patients
Effects of Postural Changes On Epidural Pressure and Cerebral Perfusion Pressure in Patients With Serious Intracranial Lesions
Positive End-Expiratory Pressure in Supine and Sitting Positions: Its Effects on Intrathoracic and Intracranial Pressures
Panel 2: Cerebrovascular Dynamics
Bayer Round-Table Discussion on Methodology of Head Injury Trials
Initial Assessment, Interim Monitoring and Final Outcome in Clinical Studies of Head Injury
Lessons in Clinical Trial Design from the Traumatic Coma Data Bank
Consequences for Trials of Variations in the Management of Severe Head Injuries
Practical Problems During the Nimodipine Head Injury Trial II
Session V: Head Injury
Experimental
Concussive Brain Injury Produces a State of Vulnerability for Intracranial Pressure Perturbation in the Absence of Morphological Damage
Cerebral Blood Flow and Glucose Metabolism Following Experimental Head Injury
Effect of Posttraumatic Hypoventilation
The Role of LTC4 in the Development of Post-Traumatic Intracranial Hypertension
Changes in Cerebrovascular Permeability and Excitatory Amino Acid-Mediated Cellular Swelling Following Experimental Concussive Brain Injury
Lack of Relationship between Hippocampal Cell Loss and ICP After Experimental Head Injury
Computerized Tomography and Magnetic Resonance Imaging
CT Scan Predictors of Intracranial Hypertension After Head Injury
Revaluation of Closed Head Injury: Comparative Study of MR and CT
CT and MRI Evaluation of Traumatic Brain Edema and its Biochemical and Histological Correlates
Post-Traumatic Ventricular Enlargement in the Traumatic Coma Data Bank: Incidence, Risk Factors, and Influence on Outcome
ICP Monitoring
Secondary Rise of Intracranial Pressure Following Severe Head Injury
Characteristics of ICP of Head Injury in the Elderly
Transporting and Monitoring the Head-Injured Patient
Intracranial Pressure Monitoring in Multidisciplinary Care Unit
Intracranial Pressure Related to Sleep
Edema, Hemodynamics and Oxygenation
The Contribution of Brain Edema to Brain Swelling
Cerebral Blood Volume in Acute Head Injury: Relationship to CBF and ICP
Intracranial Compliance and Cerebral Hemodynamics in Head-Injured Patients
Cerebral Perfusion Pressure Management of Head Injury
Intracranial and Cerebral Perfusion Pressure Monitoring in the Head Injured Patient: Which Index?
Relationship between Cerebral Oxygenation and Perfusion Pressure in Acute Brain Injury
Multimodality Monitoring of Intracranial Pressure Therapy After Severe Brain Injury
CPP and SJO2 with ICP Reduction Therapy after Severe Head Injury
Diffuse Axonal Injury
ICP Monitoring of Severe Diffuse Axonal Injury
Diffuse Traumatic Axonal Injury: A Longitudinal Study
"Pure" Diffuse Axonal Injuries with Multiple Lesions on CT-Scan: Analysis of 20 Consecutive Patients
Diffuse Axonal Injury: Changes of Cerebral Blood Flow, Intracranial Pressure and Evoked Potentials
Session VI: Control of ICP
Hyperventilation
Ischemic Insult Due to Manual Ventilation in Head Injured Patients with Intracranial Hypertension
Is There a Risk to Induce Ischemia by Hyperventilation Therapy?
Osmotic and Other Agents
Effects of Mannitol Treatment on Cerebral Water Content
Pharmacokinetic Analysis of Mannitol in Relation to the Decrease of ICP
The Early Role of Mannitol-Induced Hemodynamic Changes in the Control of Intracranial Hypertension
A Comparison Study Between Mannitol and Glycerol Therapy in Reducing Intracranial Pressure
A Pilot Study on Postoperative ICP Control by Glycerin Combined with Lidocaine or Nitroglycerin
Effect of Hypertonic-Hyperoncotic Solutions (HHS) on Increased Intracranial Pressure after a Focal Brain Lesion and Inflation of an Epidural Balloon
A Prospective Randomized Clinical Trial of Tromethamine (THAM) and its Effect Upon Outcome in Severe Head Injury
Correction of CSF Acidosis and Craniospinal System Viscoelastic Parameters with Intrathecal THAM
Comparison of Thiopentone and Propofol at Two Rates of Intravenous Administration in Severely Head Injured Patients
Propofol Vs Thiopental for the Control of Elevated ICP in Head Injured Patients
Hypotensive Agents
Comparison of Sodium Nitroprusside and Labetalol on the Intracranial Pressure of Cats
Cerebral Hemodynamic Response of Sodium Nitroprusside and Esmolol
ICP and Systemic Blood Pressure Changes After Administration of Prostaglandin E1 in Acute Stage of SAH
Anesthetic Agents
Influence of Isoflurane on Cerebrospinal Fluid Pressure and Cerebral Blood Flow Velocity
Isoflurane Vs. Nitrous Oxide: Impact on Cerebrospinal Fluid Pressure in Anesthetized Patients with Brain Tumors
Influence of Anesthetic Agents on the Regional Cerebral Blood Flow in Rabbits with a Focal Cerebral Lesion and General Hypoxia
Brain Blood Volume and Cerebral Hemodynamics in the Anesthetized Rat
Flumazenil and ICP Changes during Reversal of Benezodiazepine Sedation
Effect of Propofol on Cerebro-Spinal Fluid Pressure in Patients with and without Intracranial Hypertension
Intracranial Pressure, Pressure-Volume Index and Cerebral Perfusion Pressure During Anaesthesia with Propofol in Neurosurgery
Succinylcholine, Motor Deficits, Intracranial Hypertension and Potassium Levels in Brain Tumour Patients
Miscellaneous
Surgical Decision-Making in Patients with Traumatic Contusion and Intracerebral Haematoma - ICP Monitoring or CT Scanning?
Spontaneously Disappearing Acute Subdural Hematomas: Conservative Treatment with Intracranial Pressure Monitoring
How to Reduce the Ischemic Brain Damage Secondary to Severe Head Injury?
Toxic Effects of Nutritional Support in the Severely Head Injured Patient
Panel 3: Head Injury and Control of ICP
Session VII: CSF Dynamics
Models
The Dynamics of Cerebral Blood Flow, Perfusion Pressure and CSF Circulation - A Modelling Study
Interfering Factors in Cerebrospinal Parameter Estimation
Elevated Venous Outflow Pressure in Head Injured Patients
A Finite Element Analysis of Intracerebral Stress Distribution with Viscoelastic Model
Experimentally Derived Law Governing the Time Relationship of a Pressure-Volume Adjustment in the Human Craniospinal System - A Diagnostic and Management Tool
Dynamics and Statics of the Cerebrospinal Fluid: The Classical and a New Hypothesis
Hydrostatic Force in Regulation of CSF Volume
Osmotic Force of the CSF and Intracranial Pressure in Health and Disease
CSF Outflow Resistance and Volume-Pressure Relationship
CSF Dynamics and Cerebral Hemodynamics in ATP-Induced Hypotension
Computerized Infusion Test Compared to Conventional Lumbo-Ventricular Perfusion for Measurement of Resistance to CSF-Outflow
Comparison of Lumbar and Ventricular Constant Flow and Bolus Infusions in Hydrocephalus
Normal CSF Dynamics in Man. Estimation of Pressure-Volume Index and Resistance to Outflow of CSF in Adults Without Intracranial Pathology
Intracranial Pressure and Cerebrospinal Fluid Dynamics in the Adult Chronic Hydrocephalus Syndrome
Plateau Waves and Cerebrospinal Fluid Circulation
Heart Rate Variability During Infusion Tests
Identification of the Cerebrospinal Compensatory Mechanisms via Computer Controlled Drainage of Cerebrospinal Fluid
The Pressure-Volume Index (PVI) with Epidural Mass Expansion
Relationship Between Pressure-Volume Index and AMP/ICP When the PaCO2 is Changed
Magnetic Resonance Imaging
Bulk Flow and To-and-Fro Flow of CSF Observed on MRI and CT Cisternography
CSF Flow Analysis Using Cine MRI in Patients with Hydrocephalic States
Quantitative Analysis of CSF Pulsatile Flow in the Aqueduct with Dynamic MRI and Presaturation Bolus Tracking: The Flow Patterns and Clinical Aspects in Adults with Communicating Hydrocephalus
Aqueductal CSF Flow on MRI and its Relation to Intracranial Pressure Dynamics
Brain Edema Induced by Ventricular Puncture. A Study by Magnetic Resonance Imaging
Session VIII: Hydrocephalus
Normal Pressure Hydrocephalus
Hydrocephalus-Analysis of 480 Infusion Tests
Evaluation of Pressure Monitoring and CSF Conductance in NPH
The Relative Prognostic Value of CSF Outflow Resistance Measurement in Shunting for Normal Pressure Hydrocephalus
A Ventricular Infusion Technique for the Evaluation of Treated and Untreated Hydrocephalus
Quantitative Analysis of Different Curves of Lumbar Repetitive Bolus Infusion Test in Patients with Ventriculomegaly
Post-Shunting Improvement in Hydrocephalic Patients Described by Cerebrospinal Compensatory Parameters
Diagnostic and Predictive Value of Axial and Coronal Spect with Technetium-99m Labelled D,L-Hexamethyl-Propylene Amine Oxime (99mTC HM-PAO) in Patients with Normal Pressure Hydrocephalus Syndrome (NPH)
Hydrocephalus Following Subarachnoid Haemorrhage
Hydrocephalus Following Aneurysmal Subarachnoid Haemorrhage and Requiring Permanent Shunt
Idiopathic Vs. Post-SAH Normal Pressure Hydrocephalus
Dynamics of Hydrocephalus Development After Spontaneous Subarachnoid Hemorrhage
Management Problems in Acute Hydrocephalus After Subarachnoid Hemorrhage
Infantile Hydrocephalus
Continuous Intraventricular Pressure and Simultaneous Cerebral Blood Flow Velocity (CBFV) Measurements During Sleep In Hydrocephalic Children
A Volume-Blood Flow Velocity (VFR) Relationship Derived From CSF Compartment Challenge as an Index of Progression of Infantile Hydrocephalus
Non-Invasive ICP-Monitoring in Childhood Hydrocephalus: A Comparison Between Anterior Fontanelle Pressure and Transcranial Doppler
ICP and TCD Guided Treatment of Slit Ventricle Syndrome
Cerebrospinal Compensation in Hydrocephalic Children
Surgical Vs. Non Surgical Treatment of Neonatal Intra-Ventricular Hemorrhage
CSF Shunts
The Effect of Body Position on Cerebral Blood Flow in Normal Subjects and Subjects with Shunts
Chronologic Changes in Intraventricular Pressure and Ventricular Size After Ventriculo-Peritoneal Shunt-Telemetric Measurement Using Osaka Telesensor (NS-20)
Changes of ICP After Shunt Surgery for Hydrocephalus - Long Time Evaluation by Telemetric Sensors
Long Term in Vitro Test Results of Various New and Explanted Hydrocephalus Shunt Valves
Flow-Regulating Devices Vs. Differential Pressure Valves In the Treatment of Triventricular Hydrocephalus
Non-Invasive Quantification of CSF Flow in Shunts
Application of Digital Subtraction Angiography for Quantitative Estimation of Shunt Function
Non-Invasive Measurement of ICP in Shunt System by Collapse Technique
Complications and Malfunctions of Derivative Surgery for Hydrocephalus
Panel 4: CSF Dynamics and Hydrocephalus.