VER the last 10 years there has been a growing number of clinical observations concerning the alteration of respiratory function with disease of the central nervous system. 1~,~8,34 37,55 Within the specific field of head injury and increased intracranial pressure, improved monitoring techniques have called attention to the relationship of intracranial pressure waves and respiratory patterns. ~s Equally important, and intimately related, have been the observations concerning blood gas and acid-base alterations in head injury, and their prognostic significance. 5,1s,33,5~ These changes in the blood gases and acid-base balance alter the caliber of the cerebral vessels and the rate of cerebral blood flow. These in turn further increase the intracranial pressure. Clinical observations of our own have led us to believe that alterations in respiratory pattern may well be one of the earliest signs of increased intracranial pressure, far preceding the classical symptoms of clinically observed changes in pulse and blood pressure. This paper reports an investigation of the interrelationship of intracranial pressure, respiration, and blood gases under a controlled situation, using an extradural balloon to simulate compression of an epidural hematoma. 19,2~ Such a model, while subject to the criticism that relatively slow compression by a balloon simulates only one form of acute injury, is nevertheless controllable and repeatable. The absence of other factors in acute injury, such as acceleration, deceleration, contusion, hemorrhage, and laceration, limits the injurious effects studied primarily to those caused by compression and its resultant distortion; the method also provides means for careful monitoring of these effects.
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Moody et al. (1969) studied this question.