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Kulikov A.S.

Burdenko National Medical Research Center for Neurosurgery, Moscow, Russia

Kurbasov A.A.

Burdenko Neurosurgical Center, Moscow, Russia

Lubnin A.Yu.

Moscow Regional Research Institute of Obstetrics and Gynecology, Ministry of Health of the Moscow Region, Moscow, Russia, N.N. Burdenko Research Institute of Neurosurgery, Moscow, Russia, Department of Obstetrics and Gynecology, M.F. Vladimirsky Moscow Regional Research Clinical Institute, Moscow, Russia

Brain tissue relaxation in craniotomy: a modern view of the perennial problem

Authors:

Kulikov A.S., Kurbasov A.A., Lubnin A.Yu.

More about the authors

Journal: Burdenko's Journal of Neurosurgery. 2019;83(6): 120‑126

DOI: 10.17116/neiro201983061120

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Table of contents

BRAIN TISSUE RELAXATION IN CRANIOTOMY: A MODERN VIEW OF THE PERENNIAL PROBLEM
BRAIN TISSUE RELAXATION IN CRANIOTOMY: A MODERN VIEW OF THE PERENNIAL PROBLEM

To cite this article:

Kulikov AS, Kurbasov AA, Lubnin AYu. Brain tissue relaxation in craniotomy: a modern view of the perennial problem. Burdenko's Journal of Neurosurgery. 2019;83(6):120‑126. (In Russ., In Engl.)
https://doi.org/10.17116/neiro201983061120

Подписка 2025 Журнал «Вопросы нейрохирургии» имени Н.Н. Бурденко (Burdenko's Journal of Neurosurgery)
МСФ на ЯМ
Использование инфографики авторами научных работ
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Abstract:

Intraoperative relaxation of brain tissue is one of the important factors affecting the quality and successful outcome of neurosurgical interventions. Despite many clinical studies on the problem of brain bulging, many issues remain not fully resolved. First of all, these are safety aspects of the preventive and therapeutic use of various strategies to fight this phenomenon, development of indications for introduction of hyperosmotic solutions, and use of hyperventilation or lifting of the head end of the operating table.

Keywords:

brain relaxation
brain herniation
tight brain

Authors:

Kulikov A.S.

Burdenko National Medical Research Center for Neurosurgery, Moscow, Russia

Kurbasov A.A.

Burdenko Neurosurgical Center, Moscow, Russia

Lubnin A.Yu.

Moscow Regional Research Institute of Obstetrics and Gynecology, Ministry of Health of the Moscow Region, Moscow, Russia, N.N. Burdenko Research Institute of Neurosurgery, Moscow, Russia, Department of Obstetrics and Gynecology, M.F. Vladimirsky Moscow Regional Research Clinical Institute, Moscow, Russia

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References:

  1. Lubnin AYu, Luk’yanov VI, Korshunov AG, Goriachev AS. Retraction pressure: a new parameter of intraoperative monitoring in neurosurgical patients. Anesteziologiya i reanimatologiya. 1996;2:32-39. (In Russ.)
  2. Zhong J, Dujovny M, Perlin AR, Perez-Arjona E, Park HK, Diaz FG. Brain retraction injury. Neurological Research. 2003;25:831-838. https://doi.org/10.1179/016164103771953925
  3. Li J, Gelb AW, Flexman AM, Ji F, Meng L. Definition, evaluation, and management of brain relaxation during craniotomy. British Journal of Anaesthesia. 2016;116(6):759-769. https://doi.org/10.1093/bja/aew096
  4. Rasmussen M, Bundgaard H, Cold GE. Craniotomy for supratentorial brain tumors: risk factors for brain swelling after opening the dura mater. Journal of Neurosurgery. 2004;101(4):621-626. https://doi.org/10.3171/jns.2004.101.4.0621
  5. Todd MM, Warner DS, Sokoll MD, Maktabi MA, Hindman BJ, Scamman FL, Kirschner J. A prospective, comparative trial of three anesthetics for elective supratentorial craniotomy. Propofol/fentanyl, isoflurane/nitrous oxide, and fentanyl/nitrous oxide. Anesthesiology. 1993;78(6):1005-1020. https://doi.org/10.1097/00000542-199306000-00002
  6. Whittle IR, Viswanathan R. Acute intraoperative brain herniation during elective neurosurgery: pathophysiology and management considerations. Journal of Neurology, Neurosurgery, and Psychiatry. 1996;61(6):584-590. https://doi.org/10.1136/jnnp.61.6.584
  7. Turner CR, Losasso TJ, Muzzi DA, Weglinski MR. Brain relaxation and cerebrospinal fluid pressure during craniotomy for resection of supratentorial mass lesions. Journal of Neurosurgical Anesthesiology. 1996;8(2):126-132. https://doi.org/10.1097/00008506-199604000-00005
  8. Cold GE, Tange M, Jensen TM, Ottesen S. Subdural pressure measurement during craniotomy. Correlation with tactile estimation of dural tension and brain herniation after opening of dura. British Journal of Neurosurgery. 1996;10(1):69-75. https://doi.org/10.1080/02688699650040548
  9. Bundgaard H, Landsfeldt U, Cold GE. Subdural monitoring of ICP during craniotomy: thresholds of cerebral swelling/herniation. Acta Neurochirurgica. Supplement. 1998;71:276-278. https://doi.org/10.1007/978-3-7091-6475-4_80
  10. Jorgensen HA, Bundgaard H, Cold GE. Subdural pressure measurement during posterior fossa surgery. Correlation studies of brain swelling/herniation after dural incision with measurement of subdural pressure and tactile estimation of dural tension. British Journal of Neurosurgery. 1999;13(5):449-453. https://doi.org/10.1080/02688699908540616
  11. Iversen BN, Rasmussen M, Cold GE. The relationship between intracranial pressure and the degree of brain swelling in patients subjected to infratentorial surgery. Acta Neurochirurgica. 2008;150(4):337-344. https://doi.org/10.1007/s00701-008-1461-1
  12. Hans P, Bonhomme V. Why we still use intravenous drugs as the basic regimen for neurosurgical anaesthesia. Current Opinion in Anaesthesiology. 2006;19(5):498-503. https://doi.org/10.1097/01.aco.0000245274.69292.ad
  13. Chui J, Mariappan R, Mehta J, Manninen P, Venkatraghavan L. Comparison of propofol and volatile agents for maintenance of anesthesia during elective craniotomy procedures: systematic review and meta-analysis. Canadian Journal of Anesthesia. 2014;61(4):347-356. https://doi.org/10.1007/s12630-014-0118-9
  14. Prabhakar H, Singh GP, Mahajan C, Kapoor I, Kalaivani M, Anand V. Intravenous versus inhalational techniques for rapid emergence from anaesthesia in patients undergoing brain tumour surgery. The Cochrane Database of Systematic Reviews. 2016;9:CD010467. https://doi.org/10.1002/14651858.cd010467.pub2
  15. Bastola P, Bhagat H, Wig J. Comparative evaluation of propofol, sevoflurane and desflurane for neuroanaesthesia: A prospective randomised study in patients undergoing elective supratentorial craniotomy. Indian Journal of Anesthesia. 2015;59(5):287-294. https://doi.org/10.4103/0019-5049.156868
  16. Sneyd JR, Andrews CJ, Tsubokawa T. Comparison of propofol/remifentanil and sevoflurane/remifentanil for maintenance of anaesthesia for elective intracranial surgery. British Journal of Anaesthesia. 2005;94(6):778-783. https://doi.org/10.1093/bja/aei141
  17. Petersen KD, Landsfeldt U, Cold GE, Petersen CB, Mau S, Hauerberg J, Holst P, Olsen KS. Intracranial pressure and cerebral hemodynamic in patients with cerebral tumors: a randomized prospective study of patients subjected to craniotomy in propofol-fentanyl, isoflurane-fentanyl, or sevoflurane-fentanyl anesthesia. Anesthesiology. 2003;98(2):329-336. https://doi.org/10.1097/00000542-200302000-00010
  18. Santra S, Das B. Subdural pressure and brain condition during propofol vs isoflurane-nitrous oxide anaesthesia in patients undergoing elective supratentorial tumour surgery. Indian Journal of Anesthesia. 2009;53(1):44-51.
  19. Quentin C, Charbonneau S, Moumdjian R, Lallo A, Bouthilier A, Fournier-Gosselin MP, Bojanowski M, Ruel M, Sylvestre MP, Girard F. A comparison of two doses of mannitol on brain relaxation during supratentorial brain tumor craniotomy: a randomized trial. Anesthesia and Analgesia. 2013;116(4):862-868. https://doi.org/10.1213/ane.0b013e318282dc70
  20. Seo H, Kim E, Jung H, Lim YJ, Kim JW, Park CK, Se YB, Jeon YT, Hwang JW, Park HP. A prospective randomized trial of the optimal dose of mannitol for intraoperative brain relaxation in patients undergoing craniotomy for supratentorial brain tumor resection. Journal of Neurosurgery. 2017;126(6):1839-1846. https://doi.org/10.3171/2016.6.jns16537
  21. Bebawy JF, Ramaiah VK, Zeeni C, Hemmer LB, Koht A, Gupta DK. The effect of furosemide on intravascular volume status and electrolytes in patients receiving mannitol: an intraoperative safety analysis. Journal of Neurosurgical Anesthesiology. 2013;25(1):51-54. https://doi.org/10.1097/ana.0b013e318269c335
  22. Akcil EF, Dilmen OK, Karabulut ES, Koksal SS, Altindas F, Tunali Y. Effective and safe mannitol administration in patients undergoing supratentorial tumor surgery: A prospective, randomized and double blind study. Clinical Neurology and Neurosurgery. 2017;159:55-61. https://doi.org/10.1016/j.clineuro.2017.05.018
  23. Todd MM, Cutkomp J, Brian JE. Influence of mannitol and furosemide, alone and in combination, on brain water content after fluid percussion injury. Anesthesiology. 2006;105(6):1176-1181. https://doi.org/10.1097/00000542-200612000-00017
  24. Hernández-Palazón J, Fuentes-García D, Doménech-Asensi P, Piqueras-Pérez C, Falcón-Araña L, Burguillos-López S. A comparison of equivolume, equiosmolar solutions of hypertonic saline and mannitol for brain relaxation during elective supratentorial craniotomy. British Journal of Neurosurgery. 2016;30(1):70-75. https://doi.org/10.3109/02688697.2015.1109061
  25. Raghava A, Bidkar PU, Prakash MV, Hemavathy B. Comparison of equiosmolar concentrations of hypertonic saline and mannitol for intraoperative lax brain in patients undergoing craniotomy. Surgical Neurology International. 2015;6:73. https://doi.org/10.4103/2152-7806.156771
  26. Ali A, Tetik A, Sabanci PA, Altun D, Sivrikoz N, Abdullah T, Aydoseli A, Sencer A, Akinci IO. Comparison of 3% Hypertonic Saline and 20% Mannitol for Reducing Intracranial Pressure in Patients Undergoing Supratentorial Brain Tumor Surgery: A Randomized, Double-blind Clinical Trial. Journal of Neurosurgical Anesthesiology. 2018;30(2):171-178. https://doi.org/10.1097/ana.0000000000000446
  27. Rozet I, Tontisirin N, Muangman S, Vavilala MS, Souter MJ, Lee LA, Kincaid MS, Britz GW, Lam AM. Effect of equiosmolar solutions of mannitol versus hypertonic saline on intraoperative brain relaxation and electrolyte balance. Anesthesiology. 2007;107(5):697-704. https://doi.org/10.1097/01.anes.0000286980.92759.94
  28. Dostal P, Dostalova V, Schreiberova J, Tyll T, Habalova J, Cerny V, Rehak S, Cesak T. A comparison of equivolume, equiosmolar solutions of hypertonic saline and mannitol for brain relaxation in patients undergoing elective intracranial tumor surgery: a randomized clinical trial. Journal of Neurosurgical Anesthesiology. 2015;27(1):51-56. https://doi.org/10.1097/ana.0000000000000091
  29. Malik ZA, Mir SA, Naqash IA, Sofi KP, Wani AA. A prospective, randomized, double blind study to compare the effects of equiosmolar solutions of 3% hypertonic saline and 20% mannitol on reduction of brain-bulk during elective craniotomy for supratentorial brain tumor resection. Anesthesia, Essays and Researches. 2014;8(3):388-392. https://doi.org/10.4103/0259-1162.143155
  30. Wu CT, Chen LC, Kuo CP, Ju DT, Borel CO, Cherng CH, Wong CS. A comparison of 3% hypertonic saline and mannitol for brain relaxation during elective supratentorial brain tumor surgery. Anesthesia and Analgesia. 2010;110(3):903-907. https://doi.org/10.1213/ane.0b013e3181cb3f8b
  31. Prabhakar H, Singh GP, Anand V, Kalaivani M. Mannitol versus hypertonic saline for brain relaxation in patients undergoing craniotomy. The Cochrane Database of Systematic Reviews. 2014;7:CD010026. https://doi.org/10.1002/14651858.cd010026
  32. Shao L, Hong F, Zou Y, Hao X, Hou H, Tian M. Hypertonic saline for brain relaxation and intracranial pressure in patients undergoing neurosurgical procedures: a meta-analysis of randomized controlled trials. PLoS One. 2015;10(1):e0117314. https://doi.org/10.1371/journal.pone.0117314
  33. Fang J, Yang Y, Wang W, Liu Y, An T, Zou M, Cheng G. Comparison of equiosmolar hypertonic saline and mannitol for brain relaxation during craniotomies: A metaanalysis of randomized controlled trials. Neurosurgical Review. 2018;41(4):945-956. https://doi.org/10.1007/s10143-017-0838-8
  34. Zhang W, Neal J, Lin L, Dai F, Hersey DP, McDonagh DL, Su F, Meng L. Mannitol in Critical Care and Surgery Over 50+ Years: A Systematic Review of Randomized Controlled Trials and Complications With Metaanalysis. Journal of Neurosurgical Anesthesiology. 2019;31(3):273-284. https://doi.org/10.1097/ana.0000000000000520
  35. Hayes GJ, Slocum HC. The achievement of optimal brain relaxation by hyperventilation technics of anesthesia. Journal of Neurosurgery. 1962;19:65-70. https://doi.org/10.3171/jns.1962.19.1.0065
  36. Gelb AW, Craen RA, Rao GS, Reddy KR, Megyesi J, Mohanty B, Dash HH, Choi KC, Chan MT. Does hyperventilation improve operating condition during supratentorial craniotomy? A multicenter randomized crossover trial. Anesthesia and Analgesia. 2008;106(2):585-594. https://doi.org/10.1213/01.ane.0000295804.41688.8a
  37. Muizelaar JP, Marmarou A, Ward JD, Kontos HA, Choi SC, Becker DP, Gruemer H, Young HF. Adverse effects of prolonged hyperventilation in patients with severe head injury: a randomized clinical trial. Journal of Neurosurgery. 1991;75(5):731-739. https://doi.org/10.3171/jns.1991.75.5.0731
  38. Curley G, Kavanagh BP, Laffey JG. Hypocapnia and the injured brain: more harm than benefit. Critical Care Medicine. 2010;38(5):1348-1359. https://doi.org/10.1097/ccm.0b013e3181d8cf2b
  39. Grady MS. Editorial. Lumbar drainage for increased intracranial pressure. Journal of Neurosurgery. 2009;110(6):1198-1199. https://doi.org/10.3171/2008.11.jns081336
  40. Lubnin AYu, Luk’yanov VI, Salalykin VI, Makhmudov UB. Retraction pressure in neurosurgical interventions on the brain. Part III. Analysis of the efficiency of preventive methods aimed at reducing brain volume. Voprosy nejrohirurgii imeni N.N. Burdenko. 1995;3:21-25. (In Russ.)
  41. Stilling M, Karatasi E, Rasmussen M, Tankisi A, Juul N, Cold GE. Subdural intracranial pressure, cerebral perfusion pressure, and degree of cerebral swelling in supra- and infratentorial space-occupying lesions in children. Acta Neurochirurgica. Supplement. 2005;95:133-136. https://doi.org/10.1007/3-211-32318-x_29
  42. Tankisi A, Cold GE. Optimal reverse trendelenburg position in patients undergoing craniotomy for cerebral tumors. Journal of Neurosurgery. 2007;106(2):239-244. https://doi.org/10.3171/jns.2007.106.2.239
  43. Israelyan LA, Shimanskiy VN, Otamanov DA, Poshataev VK, Lubnin AYu. Positioning on the operating table in neurosurgery: sitting or lying. Anesteziologiya i reanimatologiya. 2013;4:18-26. (In Russ.)
  44. Dietrich J, Rao K, Pastorino S, Kesari S. Corticosteroids in brain cancer patients: benefits and pitfalls. Expert Review of Clinical Pharmacology. 2011;4(2):233-242. https://doi.org/10.1586/ecp.11.1
  45. Rasmussen M, Tankisi A, Cold GE. The effects of indomethacin on intracranial pressure and cerebral haemodynamics in patients undergoing craniotomy: a randomised prospective study. Anaesthesia. 2004;59(3):229-236. https://doi.org/10.1111/j.1365-2044.2004.03604.x
  46. Sader N, Zeiler FA, Gillman LM, West M, Kazina CJ. Indomethacin for control of ICP. Neurocritical Care. 2015;22(3):437-449. https://doi.org/10.1007/s12028-014-0088-3
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