{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T12:47:38Z","timestamp":1772110058467,"version":"3.50.1"},"reference-count":31,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2007,2]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>To the authors\u2019 knowledge, repeated measurements of intracranial pressure (ICP), cerebral perfusion pressure (CPP), and the degree of dural tension during different positions on the operating table (reverse Trendelenburg position [rTp]) have not been studied in patients undergoing craniotomy.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>In the present study 53 patients with supratentorial cerebral tumors who underwent craniotomy in the supine position were included. Subdural ICP, mean arterial blood pressure (MABP), CPP, and jugular bulb (JB) pressure were recorded, and the degree of dural tension was analyzed while patients were in the neutral operating position and at 5, 10, and 15\u00b0 rTp. The optimal operating position was defined as the one at which subdural ICP was as low as possible, and CPP was greater than or equal to 60 mm Hg or as high as possible.<\/jats:p>\n<jats:p>Subdural ICP, MABP, and JB pressure decreased significantly after each 5\u00b0 change in rTp compared with the preceding position. Dural tension decreased significantly up to 10\u00b0 rTp, but was unchanged at 15\u00b0 rTp. At 5\u00b0 rTp CPP remained unchanged, but it decreased significantly during 10 and 15\u00b0 rTp. The optimal position in the majority of patients was determined to be 15\u00b0 rTp.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Before opening the dura mater for craniotomy, repeated measurements of ICP and CPP, in the neutral position and at 5, 10, and 15\u00b0 rTp, provide valuable information regarding the optimal level of ICP and CPP.<\/jats:p><\/jats:sec>","DOI":"10.3171\/jns.2007.106.2.239","type":"journal-article","created":{"date-parts":[[2008,1,24]],"date-time":"2008-01-24T12:44:23Z","timestamp":1201178663000},"page":"239-244","source":"Crossref","is-referenced-by-count":19,"title":["Optimal reverse Trendelenburg position in patients undergoing craniotomy for cerebral tumors"],"prefix":"10.3171","volume":"106","author":[{"given":"Alp","family":"Tankisi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georg Emil","family":"Cold","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1-1060239","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"15","DOI":"10.3171\/jns.1992.77.1.0015","article-title":"Blood pressure and intracranial pressure-volume dynamics in severe head injury: relationship with cerebral blood flow","volume":"77","year":"1992"},{"key":"b2-1060239","series-title":"Br J Neurosurg","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1080\/026886900408414","article-title":"Studies of regional subdural pressure gradients during craniotomy","volume":"14","year":"2000"},{"key":"b3-1060239","series-title":"J Neurosurg Anesthesiol","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1097\/00008506-199610000-00003","article-title":"Effects of perioperative indomethacin on intracranial pressure, cerebral blood flow, and cerebral metabolism in patients subjected to craniotomy for cerebral tumors","volume":"8","year":"1996"},{"key":"b4-1060239","series-title":"Br J Neurosurg","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1080\/02688699650040548","article-title":"\u201cSubdural\u201d pressure measurement during craniotomy\u201d. 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