Search

Cerebral vessels can keep cerebral perfusion more or less constant. This process is called cerebral vasoregulation and can be measured using different neuromonitoring techniques, which will be discussed in this overview. Cerebral perfusion deficits after brain damage caused by a cerebrovascular accident (CVA), subarachnoid haemorrhage (SAH) or severe traumatic skull and brain injury (TSBI) can be detected early and better understood by using these techniques. In current clinical guidelines on the treatment of CVA, SAB and TSBI, impaired cerebral vasoregulation is often assumed. However, there is a need to measure cerebral vasoregulation status at the individual level, with follow-up over time. Some vasoregulation techniques inform the clinician about subtle local regulation disorders ('snapshot' assessment). Other techniques are suitable for the global long-term monitoring of vasoregulation ('monitoring' assessment) where the results could serve as feedback for treatment interventions. Appropriate use of the techniques in daily clinical practice requires standardisation of the methods available for the monitoring of cerebral vasoregulation. Presently, use is mostly restricted to the research setting.

An 8-year old boy had earache and vomiting due to otomastoiditis with acute thrombosis of the sinus sigmoideus.

A sub-aponeurotic fluid collection (an extracranial fluid accumulation between the galea aponeurotica and the periostium of the scalp) of 2 week duration was observed in a 2.5-month-old male infant. In contrast to a subgaleal bleeding, which occurs on the first day after birth and is of a progressive nature, swelling caused by sub-aponeurotic fluid collection does not occur until a few weeks after birth and shows a benign course. The exact etiological mechanism of this fluid collection is unknown. It is probable that temporary (micro) fluid fistula, as a result of birth trauma, plays a role. Management is conservative, and complete reabsorption can be expected within a few weeks to months at the most.