Auer L, Oberbauer R, Tritthart H
Neurochirurgia (Stuttg). 1977 Mar;20(2):48-55. doi: 10.1055/s-0028-1090354.
It is not only for CSF-removal in conservative treatment of oedema and control of the effectiveness of osmo-onco-therapy, contricosteroids, anticholinergics and aldosterone-antagonists, that external CSF drainage in severe cerebral trauma has proved of value. It has also made it possible to assess objectively the indications for bitemporal craniotomy in raised intracrainial pressure with an acute midbrain syndrome caused by tentorial herniation. Continuous monitoring of ICP permits an intervention at the right time and prevents one from operating too late, namely at a moment, when manifest neurological signs already indicate cerebral decompensaervative steps failing, a bitemporal craniectomy is indicated: in this way we lower intracranial pressure, liberate the rostral brain stem out of its strangulation and improve cerebral perfusion and metabolism.
严重脑外伤时的外部脑脊液引流不仅在水肿的保守治疗中用于清除脑脊液以及控制渗透-肿瘤治疗、皮质类固醇、抗胆碱能药物和醛固酮拮抗剂的疗效方面已证明具有价值。它还使得能够客观评估因小脑幕切迹疝导致急性中脑综合征且颅内压升高时双侧颞部开颅手术的适应证。持续监测颅内压允许在正确的时间进行干预，并防止手术过晚，即在明显的神经体征已表明脑代偿失调步骤失败、需要进行双侧颞部颅骨切除术的时刻进行手术：通过这种方式，我们降低颅内压，解除延髓脑桥的绞窄，改善脑灌注和代谢。
