Intracranial hypertension surgery

Contraindications Active internal bleeding, AV malformation or aneurysm, bleeding diathesis, intracranial neoplasm, intracranial orintraspinal surgery or trauma, recent (within past 2 mo) cerebrovascular accident, severe uncontrolled hypertension... 

However, rewarming has to be considered as the critical phase of hypothermic therapy. This rebound intracranial hypertension after rewarming might be due to a proposed hypermetabolic response after induced hypothermia, as it was described after cardiopulmonary bypass surgery (40). 

Factors that increase the risk of bleeding must be evaluated before thrombolytic therapy is initiated (i.e., recent surgery, trauma or internal bleeding, uncontrolled hypertension, recent stroke, or intracranial hemorrhage)... 

The contraindications to the use of thrombolytic drugs are similar to those for the anticoagulant drugs. Absolute contraindications include active bleeding, cardiopulmonary resuscitation (trauma to thorax is possible), intracranial trauma, vascular disease, and cancer. Relative contraindications include uncontrolled hypertension, earlier central nervous system surgery, and any known bleeding risk. 

Other reported side effects include vomiting, salivation, lacrimation, shivering, skin rash, and an interaction with thyroid preparations that may lead to hypertension and tachycardia. Ketamine also may raise intracranial pressure and elevate pulmonary vascular resistance, especially in children with trauma or congenital heart disease. Increases in intraocular pressure also may occur, and vigilance is required if ketamine is used in ocular surgery. 

Contraindications Active internal bleeding, arteriovenous malformation or aneurysm, cerebrovascular accident (CVA) with residual neurologic defect, history of CVA (within the past 2 yr) or oral anticoagulant use within the past 7 days unless PT is less than 1.2 X control, history of vasculitis, hypersensitivity to murine proteins, intracranial neoplasm, prior IV dextran use before or during percutaneous transluminal coronary angioplasty (PTCA), recent surgery or trauma (within the past 6 wk), recent (within the past 6 wk or less) GI or GU bleeding, thrombocytopenia (less than 100,000 cells/pl), and severe uncontrolled hypertension... 

Contraindications Carcinoma of the brain, cerebrovascular accident, internal bleeding, intracranial surgery, recent streptococcal infection, severe hypertension... 

Index functional status 30 d after stroke. The results showed that only the severity of neurological deficit predicted greater 30-d mortality in these patients. Patients with hyperthermia on the first day of hospitalization had increased mortality and worse functional status at 30 d, but increased temperature was not an independent predictor of mortality 30 d after PICH. In a study to assess typical early onset complications following ischemic stroke, Weimar et al. (5) looked at a cohort of 3866 patients from 14 neurology departments with an acute stroke unit. In the first week following admission, increased intracranial pressure (ICP) and recurrent cerebral ischemia were the most frequent complications, along with fever, severe hypertension, and pneumonia. Similar concerns are also found in cardiac surgery patients in whom perioperative stroke occurred (6). 

Active internal bleeding, history of CVA, recent intracranial or intraspinal surgery or trauma, intracranial neoplasm, arteriovenous malformation or aneurysm, bleeding diathesis or severe uncontrolled hypertension (increases risk of bleeding)... 

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