ABSTRACT
The Spiegelberg device is based on air-filled balloon system and was designed for epidural ICP monitoring. Zero adjustment is done automatically with the device in situ, thus avoiding zero drift. In 14 patients with mostly severe head injury (Glasgow Coma Scale score of 8 or lower in 10 patients) and 19-84 years old monitoring was carried out during treatment in the intensive care unit. ICP values were checked by repeating functional tests of the monitoring system, by serial cranial CT, and by a study of the clinical outcomes. Four patients died. There were no technical problems or infections. Clinically reliable data were obtained in 10 patients. The ICP shown was correlated with all other parameters; it was lower than would be expected in 1, and higher in 3 patients. With six simultaneous measurements with Gaeltec ICT/b, Camino subdural or an intraventricular catheter system the values were found to correlate only in 1 case. Experimental and clinical data suggest that the Spiegelberg-monitored ICP is somewhat higher than the ICP shown by other epidural systems. Clinical trials will be continued.
Subject(s)
Craniocerebral Trauma/physiopathology , Intracranial Pressure , Monitoring, Physiologic/instrumentation , Adult , Aged , Aged, 80 and over , Craniocerebral Trauma/diagnosis , Epidural Space , Female , Glasgow Coma Scale , Humans , Male , Middle Aged , Tomography, X-Ray ComputedABSTRACT
A follow-up of 52 patients with a history of Darrach's procedure between 1961 and 1989 was carried out 16 years after surgery. 92% of those with trauma of the forearm, wrist, and distal radio-ulnar joint reported hardly any pain at all with marked improvement of forearm rotation and wrist mobility. The only drawback to surgery was an average strength loss of 50%.
