Effect of the Position of the Patient's Head

Study of the Effect of the Position of the Patient's Head With Brain Lesions on Cerebral Blood Flow

Status

Completed

Phases

Unknown

Study type

Observational

Source

ClinicalTrials.gov

Registry ID

NCT02549313

Enrollment

Registered

2015-09-15

Start date

2012-01-31

Completion date

2015-10-31

Last updated

2015-11-03

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Brain Lesion

Keywords

brain lesion, intracranial pressure, cerebral perfusion pressure

Brief summary

The position of the head of the patient influences the cerebral venous return and cerebral perfusion pressure (CPP). In our daily practice, it is almost routine to prescribe a Trendelenburg position 30 ° in all brain-damaged patients. However, this is based only on precarious bibliographic databases. It has been shown to decrease the Intracranial Pressure (ICP) in Trendelenburg position relative to the horizontal, with varying effects on PPC. Effects on sylvian objectified by Doppler velocities and cerebral oxygenation seem unaffected by changes of position of the head of the patient. But the whole of the literature on this subject has significant bias.

Detailed description

Registration of blood flow changes induced when the patient's head will be tilted at 0 ° (that is to say flat), 15 ° and 30 ° (the order of actions will be determined by randomization). The patient will remain 10 minutes in each of these positions and will also have a little extra blood sample of 1 ml (ie 9 samples). These measures will be carried out again the next day and then after five days to see if the results vary depending on the evolution of his condition.

Interventions

PROCEDUREposition changes of the head

Registration of blood flow changes induced when the patient's head will be tilted at 0 ° (that is to say flat), 15 ° and 30 ° (the order of actions will be determined by drawing lots). The patient will remain 10 minutes in each of these positions.

Study design

Observational model

COHORT

Time perspective

PROSPECTIVE

Eligibility

Sex/Gender

ALL

Age

18 Years to No maximum

Healthy volunteers

Inclusion criteria

* Patients aged over 18 years with: * A severe head injury * or subarachnoid hemorrhage before the 5th day of evolution * or spontaneous intracranial hematoma * or ischemic stroke * Neurosurgical Patients after surgery * Presenting intracranial hypertension

Exclusion criteria

* Hemodynamic and / or neurological instability. In the most unstable patients, care and mobilizations are reduced to a minimum. * Craniectomy

Design outcomes

Primary

Measure	Time frame	Description
Cerebral oxygenation	day 1	Value of cerebral oxygenation (Hg mm) after 5 minutes in each position

Countries

France

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026