Intracranial Hypertension following Acute Mesenteric Ischemia: A Case Study on the Multiple Compartment Syndrome.

Autor:	Pipolo DO; Department of Surgery, North Shore University Hospital, Manhasset, New York.; Department of Neurological Surgery, Trauma and Emergency Hospital Dr. Federico Abete, Buenos Aires, Argentina., Guevara S; Department of Surgery, North Shore University Hospital, Manhasset, New York., Vasiljevic L; Department of Pediatrics, LAC + USC Medical Center, Los Angeles, California., Pietrantonio AED; Department of Neurological Surgery, Trauma and Emergency Hospital Dr. Federico Abete, Buenos Aires, Argentina., Brennan W; Department of Neurological Surgery, Trauma and Emergency Hospital Dr. Federico Abete, Buenos Aires, Argentina., Asmus H; Department of Neurological Surgery, Trauma and Emergency Hospital Dr. Federico Abete, Buenos Aires, Argentina., McCann-Molmenti A; Department of Surgery, North Shore University Hospital, Manhasset, New York., Cho YM; Department of Rheumatology, North Shore University Hospital, Manhasset, New York., Shinozaki K; Feinstein Institutes for Medical Research, Manhasset, New York.; Department of Emergency Medicine, North Shore University Hospital, Manhasset, New York., Hayashida K; Feinstein Institutes for Medical Research, Manhasset, New York., Okuma Y; Department of Neurological Surgery, Sonoda Daiichi Hospital, Tokyo, Japan., Shoaib M; Feinstein Institutes for Medical Research, Manhasset, New York.; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York., Becker LB; Feinstein Institutes for Medical Research, Manhasset, New York.; Department of Emergency Medicine, North Shore University Hospital, Manhasset, New York.; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York., Decker ME; Department of Anesthesiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Worku HA; Department of Anesthesiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Majdak P; Department of Anesthesiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Donzelli G; Department of Anesthesiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Patel A; Department of Anesthesiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Davoud S; Department of Anesthesiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Vaca-Zorrilla A; Department of Anesthesiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Beutler SS; Department of Anesthesiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts., Molmenti EP; Department of Surgery, North Shore University Hospital, Manhasset, New York.; Feinstein Institutes for Medical Research, Manhasset, New York.; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York., Miyara SJ; Department of Anesthesiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Jazyk:	angličtina
Zdroj:	The International journal of angiology : official publication of the International College of Angiology, Inc [Int J Angiol] 2023 Mar 09; Vol. 32 (3), pp. 188-192. Date of Electronic Publication: 2023 Mar 09 (Print Publication: 2023).
DOI:	10.1055/s-0043-1763252
Abstrakt:	In this case study, we describe a 25-year-old male who was admitted due to a severe traumatic brain injury, requiring invasive intracranial pressure monitoring. At 48 hours posttrauma, he developed intracranial hypertension refractory to medical treatment without tomographic changes in the brain. Subsequently, intra-abdominal hypertension and tomographic signs of abdominal surgical pathology were observed. An exploratory laparotomy was performed with an intraoperative diagnosis of acute mesenteric ischemia. After surgical intervention for the abdominal pathology, intracranial pressure was restored to physiological values with a favorable recovery of the patient. In this report, the relationship between intracranial pressure and intra-abdominal pressure is discussed, highlighting the delicate association between the brain, abdomen, and thorax. Measures should be taken to avoid increases in intra-abdominal pressure in neurocritical patients. When treating intracranial hypertension refractory to conventional measures, abdominal causes and multiple compartment syndrome must be considered. The cranial compartment has physiological interdependence with other body compartments, where one can be modified by variations from another, giving rise to the concept of multiple compartment syndrome. Understanding this relationship is fundamental for a comprehensive approach of the neurocritical patient. To the best of our knowledge, this is the first report of a comatose patient post-traumatic brain injury, who developed medically unresponsive intracranial hypertension secondary to acute mesenteric ischemia, in which surgical resolution of intra-abdominal pathology resulted in intracranial pressure normalization and restitutio ad integrum of neurological status. Competing Interests: Conflict of Interest None declared. (International College of Angiology. This article is published by Thieme.)
Databáze:	MEDLINE
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