Contribution of CSF and vascular factors to elevation of ICP in severely head-injured patients

A. Marmarou, A. L. Maset, J. D. Ward, S. Choi, D. Brooks, H. A. Lutz, R. J. Moulton, Jan Paul Muizelaar, A. DeSalles, H. F. Young

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108 Scopus citations


The authors studied the relative contribution of cerebrospinal fluid (CSF) and vascular parameters to the level of intracranial pressure (ICP) in 34 severely head-injured patients with a Glasgow Coma Scale score of less than 8. This was accomplished by first characterizing the temporal course of CSF formation and outflow resistance during the 5-day period postinjury. The CSF formation and outflow resistance were obtained from pressure responses to bolus addition and removal of fluid from an indwelling ventricular catheter. The vascular contribution to the level of ICP was assessed by withdrawing fluid at its rate of formation and observing the resultant change in equilibrium ICP level. It was found that, with the exception of patients with subarachnoid hemorrhage, CSF parameters accounted for approximately one-third of the ICP rise after severe head injury, and that a vascular mechanism may be the predominant factor in elevation of ICP.

Original languageEnglish (US)
Pages (from-to)883-890
Number of pages8
JournalJournal of Neurosurgery
Issue number6
StatePublished - 1987
Externally publishedYes

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)


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