Principes de traitement de l’hypertension intracrânienne

  • Bertrand Fauvage
  • Jacques Albanèse
  • Jean-François Payen
Part of the Le point sur … book series (POINT)

Abstrait

L’hypertension intracrânienne (HTIC) est la conséquence de l’augmentation de volume de l’un ou de plusieurs des éléments contenus dans la cavité rigide ostéoméningée, aux capacités de compensation volumique réduite. Elle peut se développer à bas bruit ou au contraire prendre une forme rapidement menaçante selon le mécanisme en cause et sa vitesse d’apparition, ce qui rend variables les signes cliniques et paracliniques d’HTIC. Lorsque les mécanismes intracérébraux de compensation face à l’augmentation du volume sont épuisés, l’HTIC peut évoluer très rapidement et devenir responsable d’une morbidité et d’une mortalité importante. Elle devient alors une urgence thérapeutique pour prévenir deux complications majeures: l’ischémie cérébrale, diffuse ou focale, et le déplacement avec compression de structures parenchymateuses cérébrales.

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Références

  1. 1.
    Ropper AH, Rockoff MA (1993) Physiology and clinical aspects of raised intracranial pressure. In: Neurological and Neurosurgical Intensive Care, AH Ropper (ed), Raven Press, New York, pp 11–27.Google Scholar
  2. 2.
    Bissonnette B, Boulard G (2004) Physiopathologie du système nerveux central. In: Le patient neurochirurgical, P Ravussin (ed), Springer-Verlag, Paris, pp 15–32Google Scholar
  3. 3.
    Schmidt B, Czosnyka M, Schwarze JJ et al. (1999) Cerebral vasodilatation causing acute intracranial hypertension: a method for noninvasive assessment. J Cereb Blood Flow Metab 19: 990–6CrossRefPubMedGoogle Scholar
  4. 4.
    Narayan RK, Kishore PR, Becker DP et al. (1982) Intracranial pressure: to monitor or not to monitor? A review of our experience with severe head injury. J Neurosurg 56: 650–9PubMedGoogle Scholar
  5. 5.
    Czosnyka M, Richards HK, Whitehouse HE, Pickard JD (1996) Relationship between transcranial Doppler-determined pulsatility index and cerebrovascular resistance: an experimental study. J Neurosurg 84: 79–84PubMedGoogle Scholar
  6. 6.
    Czosnyka M, Matta BF, Smielewski P et al. (1998) Cerebral perfusion pressure in headinjured patients: a noninvasive assessment using transcranial Doppler ultrasonography. J Neurosurg 88: 802–8PubMedCrossRefGoogle Scholar
  7. 7.
    Chan KH, Miller JD, Dearden NM et al. (1992) The effect of changes in cerebral perfusion pressure upon middle cerebral artery blood flow velocity and jugular bulb venous oxygen saturation after severe brain injury. J Neurosurg 77: 55–61PubMedGoogle Scholar
  8. 8.
    Albeck MJ, Borgesen SE, Gjerris F et al. (1991) Intracranial pressure and cerebrospinal fluid outflow conductance in healthy subjects. J Neurosurg 74: 597–600PubMedGoogle Scholar
  9. 9.
    Czosnyka M, Pickard JD (2004) Monitoring and interpretation of intracranial pressure. J Neurol Neurosurg Psychiatry 75: 813–21CrossRefPubMedGoogle Scholar
  10. 10.
    Steiner LA, Balestreri M, Johnston AJ et al. (2005) Predicting the response of intracranial pressure to moderate hyperventilation. Acta Neurochir (Wien) 147: 477–83CrossRefGoogle Scholar
  11. 11.
    Schwab S, Steiner T, Aschoff A et al. (1998) Early hemicraniectomy in patients with complete middle cerebral artery infarction. Stroke 29: 1888–93PubMedGoogle Scholar
  12. 12.
    Albanese J, Leone M, Alliez JR et al. (2003) Decompressive craniectomy for severe traumatic brain injury: Evaluation of the effects at one year. Crit Care Med 31: 2535–8CrossRefPubMedGoogle Scholar
  13. 13.
    Robertson CS (2001) Management of cerebral perfusion pressure after traumatic brain injury. Anesthesiology 95: 1513–7CrossRefPubMedGoogle Scholar
  14. 14.
    Munch EC, Bauhuf C, Horn P et al. (2001) Therapy of malignant intracranial hypertension by controlled lumbar cerebrospinal fluid drainage. Crit Care Med 29: 976–81CrossRefPubMedGoogle Scholar
  15. 15.
    Muizelaar JP, Marmarou A, Ward JD et al. (1991) Adverse effects of prolonged hyperventilation in patients with severe head injury: a randomized clinical trial. J Neurosurg 75: 731–9PubMedGoogle Scholar
  16. 16.
    Sheinberg M, Kanter MJ, Robertson CS et al. (1992) Continuous monitoring of jugular venous oxygen saturation in head-injured patients. J Neurosurg 76: 212–7PubMedGoogle Scholar
  17. 17.
    Fortune JB, Feustel PJ, Graca L et al. (1995) Effect of hyperventilation, mannitol, and ventriculostomy drainage on cerebral blood flow after head injury. J Trauma 39: 1091–7PubMedCrossRefGoogle Scholar
  18. 18.
    Stocchetti N, Maas AI, Chieregato A, van der Plas AA (2005) Hyperventilation in head injury: a review. Chest 127: 1812–27CrossRefPubMedGoogle Scholar
  19. 19.
    Todd MM, Warner DS (1992) A comfortable hypothesis reevaluated. Cerebral metabolic depression and brain protection during ischemia. Anesthesiology 76: 161–4PubMedCrossRefGoogle Scholar
  20. 20.
    Albanese J, Garnier F, Bourgoin A, Leone M (2004) Les agents utilisés pour la sédation en neuro-réanimation. Ann Fr Anesth Reanim 23: 528–34CrossRefPubMedGoogle Scholar
  21. 21.
    Ward JD, Becker DP, Miller JD et al. (1985) Failure of prophylactic barbiturate coma in the treatment of severe head injury. J Neurosurg 62: 383–8PubMedCrossRefGoogle Scholar
  22. 22.
    Eisenberg HM, Frankowski RF, Contant CF et al. (1988) High-dose barbiturate control of elevated intracranial pressure in patients with severe head injury. J Neurosurg 69: 15–23PubMedGoogle Scholar
  23. 23.
    Albanese J, Viviand X, Potie F et al. (1999) Sufentanil, fentanyl, and alfentanil in head trauma patients: a study on cerebral hemodynamics. Crit Care Med 27: 407–11CrossRefPubMedGoogle Scholar
  24. 24.
    Bourgoin A, Albanese J, Wereszczynski N et al. (2003) Safety of sedation with ketamine in severe head injury patients: comparison with sufentanil. Crit Care Med 31: 711–7CrossRefPubMedGoogle Scholar
  25. 25.
    Hsiang JK, Chesnut RM, Crisp CB et al. (1994) Early, routine paralysis for intracranial pressure control in severe head injury: is it necessary? Crit Care Med 22: 1471–6CrossRefPubMedGoogle Scholar
  26. 26.
    The Brain Trauma Foundation. The American Association of Neurological Surgeons. The Joint Section on Neurotrauma and Critical Care (2000) Use of mannitol. J Neurotrauma 17: 521–5Google Scholar
  27. 27.
    Cruz J, Minoja G, Okuchi K (2001) Improving clinical outcomes from acute subdural hematomas with the emergency preoperative administration of high doses of mannitol: a randomized trial. Neurosurgery 49: 864–71CrossRefPubMedGoogle Scholar
  28. 28.
    Cruz J, Minoja G, Okuchi K (2002) Major clinical and physiological benefits of early high doses of mannitol for intraparenchymal temporal lobe hemorrhages with abnormal pupillary widening: a randomized trial. Neurosurgery 51: 628–637CrossRefPubMedGoogle Scholar
  29. 29.
    Cruz J, Minoja G, Okuchi K, Facco E (2004) Successful use of the new high-dose mannitol treatment in patients with Glasgow Coma Scale scores of 3 and bilateral abnormal pupillary widening: a randomized trial. J Neurosurg 100: 376–83PubMedGoogle Scholar
  30. 30.
    Qureshi AI, Suarez JI (2000) Use of hypertonic saline solutions in treatment of cerebral edema and intracranial hypertension. Crit Care Med 28: 3301–13CrossRefPubMedGoogle Scholar
  31. 31.
    Vialet R, Albanese J, Thomachot L et al. (2003) Isovolume hypertonic solutes (sodium chloride or mannitol) in the treatment of refractory posttraumatic intracranial hypertension: 2 mL/kg 7,5 % saline is more effective than 2 mL/kg 20 % mannitol. Crit Care Med 31: 1683–7CrossRefPubMedGoogle Scholar
  32. 32.
    Battison C, Andrews PJ, Graham C, Petty T (2005) Randomized, controlled trial on the effect of a 20 % mannitol solution and a 7,5 % saline/6 % dextran solution on increased intracranial pressure after brain injury. Crit Care Med 33: 196–202CrossRefPubMedGoogle Scholar
  33. 33.
    Dominguez TE, Priestley MA, Huh JW (2004) Caution should be exercised when maintaining a serum sodium level >160 meq/L. Crit Care Med 32: 1438–9CrossRefPubMedGoogle Scholar
  34. 34.
    Henderson WR, Dhingra VK, Chittock DR et al. (2003) Hypothermia in the management of traumatic brain injury. A systematic review and meta-analysis. Intensive Care Med 29: 1637–44CrossRefPubMedGoogle Scholar
  35. 35.
    Marion DW (2004) Controlled normothermia in neurologic intensive care. Crit Care Med 32: S43–5CrossRefPubMedGoogle Scholar
  36. 36.
    ANAES (1999) Prise en charge des traumatisés crâniens graves à la phase précoce. Recommandations pour la pratique clinique. Quelles sont les indications et les modalités des traitements médicaux de l’hypertension intracrânienne des traumatismes crâniens graves ? Ann Fr Anesth Réanim 18: 108–22Google Scholar
  37. 37.
    The Brain Trauma Foundation. The American Association of Neurological Surgeons. The Joint Section on Neurotrauma and Critical Care (2000) Guidelines for cerebral perfusion pressure. J Neurotrauma 17: 507–11Google Scholar
  38. 38.
    Coplin WM, Cullen NK, Policherla PN et al. (2001) Safety and feasibility of craniectomy with duraplasty as the initial surgical intervention for severe traumatic brain injury. J Trauma 50: 1050–9PubMedCrossRefGoogle Scholar
  39. 39.
    Martin NA, Patwardhan RV, Alexander MJ et al. (1997) Characterization of cerebral hemodynamic phases following severe head trauma: hypoperfusion, hyperemia, and vasospasm. J Neurosurg 87: 9–19PubMedGoogle Scholar
  40. 40.
    Feldman Z, Kanter MJ, Robertson CS et al. (1992) Effect of head elevation on intracranial pressure, cerebral perfusion pressure, and cerebral blood flow in head-injured patients. J Neurosurg 76: 207–11PubMedCrossRefGoogle Scholar
  41. 41.
    Diringer MN, Videen TO, Yundt K et al. (2002) Regional cerebrovascular and metabolic effects of hyperventilation after severe traumatic brain injury. J Neurosurg 96: 103–8PubMedGoogle Scholar
  42. 42.
    Oertel M, Kelly DF, Lee JH et al. (2002) Efficacy of hyperventilation, blood pressure elevation, and metabolic suppression therapy in controlling intracranial pressure after head injury. J Neurosurg 97: 1045–53PubMedCrossRefGoogle Scholar
  43. 43.
    Rosner MJ, Rosner SD, Johnson AH (1995) Cerebral perfusion pressure: management protocol and clinical results. J Neurosurg 83: 949–62PubMedCrossRefGoogle Scholar
  44. 44.
    Eker C, Asgeirsson B, Grande PO et al. (1998) Improved outcome after severe head injury with a new therapy based on principles for brain volume regulation and preserved microcirculation. Crit Care Med 26: 1881–6PubMedGoogle Scholar
  45. 45.
    Robertson CS, Valadka AB, Hannay HJ et al. (1999) Prevention of secondary ischemic insults after severe head injury. Crit Care Med 27: 2086–95CrossRefPubMedGoogle Scholar
  46. 46.
    Juul N, Morris GF, Marshall SB, Marshall LF (2000) Intracranial hypertension and cerebral perfusion pressure: influence on neurological deterioration and outcome in severe head injury. The Executive Committee of the International Selfotel Trial. J Neurosurg 92: 1–6PubMedGoogle Scholar
  47. 47.
    Elf K, Nilsson P, Ronne-Engstrom E et al. (2005) Cerebral perfusion pressure between 50 and 60 mm Hg may be beneficial in head-injured patients: a computerized secondary insult monitoring study. Neurosurgery 56: 962–71PubMedGoogle Scholar
  48. 48.
    Nordstrom CH, Reinstrup P, Xu W et al. (2003) Assessment of the lower limit for cerebral perfusion pressure in severe head injuries by bedside monitoring of regional energy metabolism. Anesthesiology 98: 809–14CrossRefPubMedGoogle Scholar
  49. 49.
    Menon DK (2003) Procrustes, the traumatic penumbra, and perfusion pressure targets in closed head injury. Anesthesiology 98: 805–7CrossRefPubMedGoogle Scholar
  50. 50.
    Pickard JD, Czosnyka M (1993) Management of raised intracranial pressure. J Neurol Neurosurg Psychiatry 56: 845–58PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag France 2007

Authors and Affiliations

  • Bertrand Fauvage
    • 1
  • Jacques Albanèse
    • 2
  • Jean-François Payen
    • 1
  1. 1.Département d’Anesthésie-Réanimation 1Hôpital MichallonGrenoble Cedex 09
  2. 2.Département d’Anesthésie-Réanimation et Centre de TraumatologieHôpital NordMarseille Cedex 20

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