Acta Neurochirurgica

, Volume 108, Issue 3–4, pp 116–121

The effects of indomethacin on intracranial pressure, cerebral blood flow and cerebral metabolism in patients with severe head injury and intracranial hypertension

  • K. Jensen
  • J. Öhrström
  • G. E. Cold
  • J. Astrup
Clinical Research

Summary

In five head-injured patients with cerebral contusion and oedema in whom it was not possible to control intracranial pressure (ICP) (ICP>20 mmHg) by artificial hyperventilation (PaCO2 level 3.5–4.0 kPa) and barbiturate sedation, indomethacin was used as a vasoconstrictor drug. In all patients, indomethacin (a bolus injection of 30 mg, followed by 30 mg/h for seven hours) reduced ICP below 20 mmHg for several hours. Studies of cerebral circulation and metabolism during indomethacin treatment showed a decrease in CBF at 2h. After 7h, ICP remained below 20 mmHg in three patients, and these still had reduced CBF. In the other patients a return of ICP and CBF to pretreatment levels was observed. In all patients indomethacin treatment was followed by a fall in rectal temperature. These results suggest that indomethacin due to its cerebral vasoconstrictor and antipyretic effect should be considered as an alternative for treatment of ICP-hypertension in head-injured patients.

Keywords

Acute head injury barbiturate coma cerebral blood flow cerebral metabolism hyperventilation indomethacin intracranial pressure intracranial hypertension 

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Copyright information

© Springer-Verlag 1991

Authors and Affiliations

  • K. Jensen
    • 1
  • J. Öhrström
    • 2
  • G. E. Cold
    • 1
  • J. Astrup
    • 2
  1. 1.Department of NeuroanaesthesiaÅrhus KommunehospitalDenmark
  2. 2.Department of NeurosurgeryÅrhus KommunehospitalDenmark

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