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Somatosensory Evoked Potentials and Intracranial Pressure in Severe Head Injury

Published online by Cambridge University Press:  18 September 2015

Stefan J. Konasiewicz ,
Richard J. Moulton  and
Peter M. Shedden
Stefan J. Konasiewicz*
Affiliation:
Division of Neurosurgery, St. Michael’s Hospital, University of Toronto, Toronto
Richard J. Moulton
Affiliation:
Division of Neurosurgery, St. Michael’s Hospital, University of Toronto, Toronto
Peter M. Shedden
Affiliation:
Division of Neurosurgery, St. Michael’s Hospital, University of Toronto, Toronto
*
Division of Neurosurgery. St. Michael’s Hospital, 38 Shuter Street, Toronto, Ontario, Canada M5B 1A6
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Abstract:

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The purpose of this study was to explore the relationship between neurologic function, using a quantitative measurement of continuous somatosensory evoked potentials (SSEPs), and intracranial pressure (ICP) following traumatic brain injury. During a 6 year period, severely head-injured patients with a Glascow Coma Scale ≤ 8 who were not moribund were monitored with SSEPs and ICP measurements. SSEPs from each hemisphere and ICP were recorded hourly for each patient. Neurologic outcomes were scored using the Glasgow Outcome Scale at three months post injury. Although initial SSEP amplitude did not correlate well with outcome, final SSEP summed peak to peak amplitude from both hemispheres (p = .0001), the best hemisphere (p = .0004), and the worst hemisphere (p = .0001) correlated well with the Glasgow Outcome Scale groups. Of a total of 72 patients, 40 had deteriorating SSEPs and 32 had stable or improving SSEPs. Peak ICP values were not statistically different in these groups (p = .6). Among patients with deteriorating SSEPs, 52.5% lost the greatest proportion of hemispheric electrical activity prior to ICP elevation. In the remaining patients, the percent reduction of SSEP activity after peak ICP levels was not statistically different from the percent reduction in SSEP activity prior to the peak ICP levels (p = .9). This data suggests that in a select group of patients with severe head injury, ICP does not cause SSEP deterioration, but rather is the consequence of deterioration of brain function.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 21 , Issue 3 , August 1994 , pp. 219 - 226
Copyright
Copyright © Canadian Neurological Sciences Federation 1994

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