Case 9: Intracranial Hypertension and Hydrocephalus
In this chapter, a clinical case explanatory of the various conditions relating to the pathology is presented.
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Echography and Doppler of the Brain
Chiara Robba • Giuseppe Citerio Editors
Echography and Doppler of the Brain
Editors Chiara Robba Anesthesia and Intensive Care Policlinico San Martino IRCCS for Oncology and Neuroscience Genoa Italy
Giuseppe Citerio Anesthesia Neurosurgical Intensive Care ASST Monza School of Medicine University of Milano Bicocca Milano Italy
ISBN 978-3-030-48201-5 ISBN 978-3-030-48202-2 (eBook) https://doi.org/10.1007/978-3-030-48202-2 © Springer Nature Switzerland AG 2021 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors, and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Springer imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
Foreword
The care of critically ill patients with neurological diseases is challenging, and often involves compromises to select a least-worst rather than a best option. This is particularly true in the case of neuromonitoring. Clinical monitoring of brain function in our patients is often confounded by sedative drugs, and we have to rely to a greater extent on neuroimaging and bedside monitoring devices. Imaging essentially provide snapshots of disease, rather than representing an approach to ongoing patient monitoring. As a consequence, many neuro- ICUs have had to primarily rely on multimodality physiological monitoring (intracranial pressure monitoring, often combined with brain oximetry and cerebral microdialysis) to understand evolving pathophysiology, select appropriate therapies, and assess their impact. However, the risks involved make their use inappropriate in patients with less severe disease, in the prehospital phase, when patients are being screened before ICU admission, and after patients have left the ICU. Finally, substantial cost of disposable equipment limits their use in resource-limited contexts. There is a clear
