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Arquivos de Neuro-Psiquiatria

Print version ISSN 0004-282X

Arq. Neuro-Psiquiatr. vol.55 no.2 São Paulo June 1997

https://doi.org/10.1590/S0004-282X1997000200021 

Monitorização da pressão intracraniana como exame complementar no diagnóstico de morte encefálica: observação preliminar através do registro de dois casos

 

Intracranial pressure monitoring as a complementary diagnosis of brain death: preliminary observation through the report of two cases

 

 

Svetlana AgapejevI; Pedro Paulo Thimoteo da SilvaII; Marco Antonio ZaniniIII; Edmur Toledo PizaII

IHospital das Clínicas da Faculdade de Medicina da Universidade Estadual Paulista (UNESP), Botucatu, Estado de São Paulo: Professor Doutor, Disciplina de Neurologia
IIHospital das Clínicas da Faculdade de Medicina da Universidade Estadual Paulista (UNESP), Botucatu, Estado de São Paulo: Residente de Neurocirurgia
IIIHospital das Clínicas da Faculdade de Medicina da Universidade Estadual Paulista (UNESP), Botucatu, Estado de São Paulo: Auxiliar de Ensino, Disciplina de Neurocirurgia

 

 


RESUMO

Estudou-se retrospectivamente a evolução clínica de dois pacientes, até sua falência cardíaca irreversível (FCI), submetidos à monitorização contínua da pressão intracraniana (PIC). O estudo detalhado desses traçados mostrou que, nos dois casos a PIC atingiu valores máximos 5 e 12 h antes de ocorrer diminuição na amplitude das ondas, observada 47 e 60 h pré-FCI. Essa diminução foi progressiva e tornou-se linear cerca de 30 h antes da FCI, em ambos os casos. O diagnóstico clínico de morte encefálica (ME) foi obtido 3 e 28 hs após a linearidade do traçado. Os autores sugerem que o diagnóstico de ME pode ser definido mais precocemente com o uso da monitorização da PIC desde que o paciente não esteja sob sedação, e salientam a necessidade de mais observações, em número maior de pacientes.

Palavras-chave: pressão intracraniana, monitorização, morte encefálica.


ABSTRACT

The clinical evolution of two patients with continuous intracranial pressure (ICP) monitoring, admitted to the Intensive Care Unit of Neurology, University Hospital of Botucatu, and followed until irreversible cardiac failure (ICF) was studied retrospectively. The evolution of ICP showed that it reached a maximum 5 to 12 hours before a decrease in wave amplitude occurred (this was observed approximately 47 to 60 hours before ICF). The tracing became linear approximately 30 hours before ICF in both cases. The clinical diagnosis of brain death (BD) was obtained 3 to 28 hours after the tracing had become linear. The authors suggest that, in abscence of sedation, the diagnosis of BD may be made early with the use of ICP monitoring even before the clinical diagnosis, and emphasize the need for more observations in a larger number of patients.

Key words: intracranial pressure, monitoring, brain death.


 

 

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

 

 

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Aceite: 25-novembro-1996.

 

 

Dra. Svetlana Agapejev - Departamento de Neurologia - Faculdade de Medicina, UNESP - Caixa Postal 540 -18618-000 Botucatu SP - Brasil.

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