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KMID : 1001920030340010027
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Journal of Korean Neurosurgical Society
2003 Volume.34 No. 1 p.27 ~ p.32
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Control of Brain Retraction Pressure Using Epidural Intracranial Pressure Monitor System in Early Aneurysm Surgery
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Sung Jae-Hoon
Lee Sang-Won
Choi Seung-Jin
Hong Jae-Taek
Woo Hee-Kyung
Kim Moon-Chan
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Abstract
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Objective : To prevent retraction induced cerebral contusion during early aneurysm surgery, we propose a simple technical tip using commonly available Spiegelberg
Methods : In this study, twenty six cases of early aneurysm clipping were enrolled. Routine pterional approach were performed. The air-pouch end of epidural ICP system was attached to the tip of Yasargil(& retractor and the other end of connecter jack was plugged in digital converter. At each stage of approach, the value of retraction power was kept a record. Immediate feedback calls were announced in case of over 25mmHg of the values.
Results : The average retraction pressure values at each stage were as follows. At the state of initial optic nerve confirmation, it was about 39 10.5mmHg. After immediate intentional re-adjust of the retraction power, it reduced to 22.8 4.5mmHg. After sufficient suck out of cerebrospinal fluid(CSF), it more reduced to 11.7 3.2mmHg. At the stage of juxta-aneurysmal brain retraction, it was about 9.0 4.1 mmHg. By the aid of this system, no retraction induced contusion or hemorrhage were occurred.
Conclusion : This data indicate the usefulness of epidural ICP sensor attached brain retractor for real time feedback of retraction power. It may be another safeguard for successful early aneurysm surgery.
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KEYWORD
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Aneurysm, Epidural space intracranial pressure, Intraoperative monitor
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