Objective: To define the correlation between the temporal course of amplitude variations of SEPSs primary complex (N20/P25) and intracranial pressure (ICP) increases (>25mmHg), and the possible mechanisms of neurological deterioration by analyzing the neuroimaging, metabolics and haemodynamics data. Design: Prospective clinical study. Setting and patients: We made a prospective study on 40 patients with SHI in the acute phase with a GCS <8 from 15 to 75 yrs of age. All the patients were submitted to ICP monitoring through external shunt. SEPSs were performed daily at patient's bedside. The outcome was evaluated by telephone interview at 6 months after trauma using the GOS. Results: The correlation among the amplitude of the cortical complex N20-P25 daily performed bilaterally and ICP monitoring resulted not statistically significant (p <0.05). The correlation among ICP and outcome resulted not statistically significant (p <0.05). SEPS amplitude compared with the outcome is statistically significant (p = 0,001). The average of the highest readings of SjvO2 compared with SEPS is a significant correlation (p = 0,019). 15 patients with deterioration of the N20/P25 before the peak of ICP also presented ischaemic lesions. 10 patients with deterioration of SEPS amplitude following the ICP peak of ICP showed an overall damage with mass effect. Conclusions: These data favour the hypothesis that ICP is an epiphenomenon of brain damage. The variations of the amplitude of SEPS express a functional impairment of the neuronal structures well correlated with outcome.
|Translated title of the contribution||Serial somatosensory evoked potential in severe head injury: A brain function monitor|
|Number of pages||22|
|Journal||Acta Anaesthesiologica Italica / Anaesthesia and Intensive Care in Italy|
|Publication status||Published - 2008|
ASJC Scopus subject areas
- Anesthesiology and Pain Medicine