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Intracranial Pressure Response to Severe Head Injury Induced Apnea and Catecholamine Surge

Anderson, Robert E. BS; Atkinson, John L. D. MD, FACS

Journal of Trauma and Acute Care Surgery: March 2003 - Volume 54 - Issue 3 - p 550-554
doi: 10.1097/01.TA.0000047049.64695.69
Original Articles

Background  Apnea and catecholamine surge have been known sequelae in the first few minutes of postexperimentally induced severe head injury for over a century. However, the intracranial pressure (ICP) response to these two pathophysiologic processes is poorly understood.

Methods  We used the rat fluid percussion head injury model to study apnea and catecholamine surge separately and in combination on measured ICP response.

Results  The three experimental groups of apnea, hypertensive surge, and both combined revealed significantly different ICP responses with markedly elevated pressures correlating closely with mean arterial blood pressure.

Conclusion  ICP and mean arterial blood pressure correlate closely in the first few minutes after head injury in the absence of space-occupying hematomas, and may initiate pathophysiologic sequelae that can only be treated by earlier medical intervention at the scene.

From the Sundt Neurosurgery Research Laboratory, Department of Neurological Surgery, Mayo Clinic and Mayo Foundation, Rochester, Minnesota.

Submitted for publication November 19, 2001.

Accepted for publication March 4, 2002.

Address for reprints: John L.D. Atkinson, MD, Department of Neurosurgery, Mayo Clinic, 200 First Street S.W., Rochester, MN 55905; email: atkinson.john@mayo.edu.

© 2003 Lippincott Williams & Wilkins, Inc.