Principles and Management of Increased Intracranial Pressure

2021 ◽  
pp. 466-472
Author(s):  
Shivram Kumar ◽  
Eelco F. M. Wijdicks
Keyword(s):  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Brain Tissue ◽  
Cerebral Perfusion Pressure ◽  
Cerebral Perfusion ◽  
Early Recognition ◽  
Increased Intracranial Pressure ◽  
Irreversible Damage ◽  
Brainstem Injury ◽  
Increased Icp

Intracranial pressure (ICP) is a reflection of the total volume inside the skull. Normal ICP is 5 to 15 mm Hg. Intracranial hypertension is defined as sustained ICP of more than 20 mm Hg. Increased ICP may lead to a reduction of cerebral perfusion pressure, a shift of brain tissue, and, as a result, secondary brainstem injury. Early recognition and treatment of elevated ICP are needed to prevent irreversible damage.

Transcranial Doppler ultrasonography in raised intra-cranial pressure and in intracranial circulatory arrest

1988 ◽  
Vol 68 (5) ◽  
pp. 745-751 ◽  
Author(s):  
Werner Hassler ◽  
Helmuth Steinmetz ◽  
Jan Gawlowski
Keyword(s):  
Intracranial Pressure ◽  
Brain Death ◽  
Intracranial Hypertension ◽  
Cerebral Perfusion Pressure ◽  
Transcranial Doppler ◽  
Cerebral Perfusion ◽  
Doppler Ultrasonography ◽  
Perfusion Pressure ◽  
Circulatory Arrest ◽  
Transcranial Doppler Ultrasonography

✓ Transcranial Doppler ultrasonography was used to monitor 71 patients suffering from intracranial hypertension with subsequent brain death. Among these, 29 patients were also assessed for systemic arterial pressure and epidural intracranial pressure, so that a correlation between cerebral perfusion pressure and the Doppler ultrasonography waveforms could be established. Four-vessel angiography was also performed in 33 patients after clinical brain death. With increasing intracranial pressure, the transcranial Doppler ultrasonography waveforms exhibited different characteristic high-resistance profiles with first low, then zero, and then reversed diastolic flow velocities, depending on the relationship between intracranial pressure and blood pressure (that is, cerebral perfusion pressure). This study shows that transcranial. Doppler ultrasonography may be used to assess the degree of intracranial hypertension. This technique further provides a practicable, noninvasive bedside monitor of therapeutic measures.

Effects of increased intracranial pressure on cerebral blood volume, blood flow, and oxygen utilization in monkeys

1975 ◽  
Vol 43 (4) ◽  
pp. 385-398 ◽  
Author(s):  
Robert L. Grubb ◽  
Marcus E. Raichle ◽  
Michael E. Phelps ◽  
Robert A. Ratcheson
Keyword(s):  
Blood Flow ◽  
Intracranial Pressure ◽  
Metabolic Rate ◽  
Intracranial Hypertension ◽  
Cerebral Perfusion Pressure ◽  
Blood Volume ◽  
Cerebral Perfusion ◽  
Cerebral Blood Volume ◽  
Perfusion Pressure ◽  
Cerebral Metabolic Rate

✓ The relationship of cerebral blood volume (CBV) to cerebral perfusion pressure (CPP), cerebral blood flow (CBF), and the cerebral metabolic rate for oxygen (CMRO2) was examined in rhesus monkeys. In vivo tracer methods employing radioactive oxygen-15 were used to measure CBV, CBF, and CMRO2. Cerebral perfusion pressure was decreased by raising the intracranial pressure (ICP) by infusion of artificial cerebrospinal fluid (CSF) into the cisterna magna. The production of progressive intracranial hypertension to an ICP of 70 torr (CPP of 40 torr) caused a rise in CBV accompanied by a steady CBF. With a further increase in ICP to 94 torr, CBV remained elevated without change while CBF declined significantly. Cerebral metabolic rate for oxygen did not change significantly during intracranial hypertension. For comparison, CPP was lowered by reducing mean arterial blood pressure in a second group of monkeys. Only CBF was measured in this group. In this second group of animals, the lower limit of CBF autoregulation was reached at a higher CPP (CPP ∼ 80 torr) than when an increase in ICP was employed (CPP ∼ 30 torr).

HYPERTONIC SALINE AND ITS EFFECT ON INTRACRANIAL PRESSURE, CEREBRAL PERFUSION PRESSURE, AND BRAIN TISSUE OXYGEN

Neurosurgery ◽  
2009 ◽  
Vol 65 (6) ◽  
pp. 1035-1042 ◽  
Author(s):  
Gaylan L. Rockswold ◽  
Craig A. Solid ◽  
Eduardo Paredes-Andrade ◽  
Sarah B. Rockswold ◽  
Jon T. Jancik ◽  
...  
Keyword(s):  
Intracranial Pressure ◽  
Brain Tissue ◽  
Cerebral Perfusion Pressure ◽  
Hypertonic Saline ◽  
Cerebral Perfusion ◽  
Perfusion Pressure ◽  
Tissue Oxygen ◽  
Brain Tissue Oxygen

scholarly journals Left or right, up or down: A case for positioning of unconcious head-injured patients

Curationis ◽  
1992 ◽  
Vol 15 (1) ◽  
Author(s):  
M. Hugo
Keyword(s):  
Intracranial Pressure ◽  
Cerebral Perfusion Pressure ◽  
Nursing Care ◽  
Cerebral Perfusion ◽  
Perfusion Pressure ◽  
Negative Influence ◽  
Head Injured ◽  
Pressure Changes ◽  
Injured Patients ◽  
Increased Icp

Nursing care activities have been proved to cause increases in intracranial pressure (ICP) which could be detrimental to the patient’s health. Because positioning is one of the activities that causes the greatest pressure changes it was evaluated in this study. Cumulative increases also occur when nursing care activities are carried out in quick succession. The analysis of the data and literature suggest that the backrest position with the head of the bed elevated 30 to 45 degrees is the best position for a patient with increased ICP. If further research should prove that this position has a negative influence on the cerebral perfusion pressure, these recommendations will have to be revised.

scholarly journals Mean value of B-mode optic nerve sheath diameter as an indicator of increased intracranial pressure: a systematic review and meta-analysis

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Lisandro Montorfano ◽  
Qian Yu ◽  
Stephen J. Bordes ◽  
Shankarapryan Sivanushanthan ◽  
Raul J. Rosenthal ◽  
...  
Keyword(s):  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Sensitivity And Specificity ◽  
Meta Analysis ◽  
Mean Value ◽  
Cochrane Library ◽  
Clinical Settings ◽  
Increased Intracranial Pressure ◽  
The Mean ◽  
Increased Icp

Abstract Objectives Timely diagnosis and treatment of increased intracranial pressure can decrease morbidity and prevent mortality. The present meta-analysis aims to determine the mean value of the ONSD measured in patients with various elevated ICP etiologies under different clinical settings, as well as comparing the value of ONSD between patients with and without elevated ICP. Methods This meta-analysis complied with the Preferred Reporting Items for Systematic Reviews and Meta-analysis Statement8. PubMed, Embase, and Cochrane Library were searched to identify ONSD measured by US for patients with increased ICP from establishment to October 2020. Results A total of 779 patients with elevated ICP among 22 studies were included in the present meta-analysis. Studies were published between 2003 and 2020. Eighteen were comparative (18/22, 81.8%), and four were single-armed study (4/22, 18.2%). Twenty were prospective studies (20/22, 90.9%). There was moderate-to-high heterogeneity based on the prediction ellipse area and variance logit of sensitivity and specificity. Conclusions The mean value of the ONSD among patients diagnosed with increased ICP was 5.82 mm (95% CI 5.58–6.06 mm). Variations were observed based on etiology of intracranial hypertension, clinical settings where ONSD was measured, and standards for diagnosing intracranial hypertension. The US-ONSD among patient with elevated ICP was significantly higher than the normal control. Although a cut-off value is not clearly determined, these mean values can be implemented to evaluate the sensitivity and specificity of US-ONSD in diagnosing intracranial hypertension in future studies.

Ketamine Induced Anesthesia in Hemorrhagic Shock and Increased Intracranial Pressure

1985 ◽  
Vol 1 (S1) ◽  
pp. 284-286
Author(s):  
Hans-Joachim Hartung ◽  
Roderich Klose ◽  
R. Kotsch ◽  
Th. Walz
Keyword(s):  
Surgical Treatment ◽  
Intracranial Pressure ◽  
Hemorrhagic Shock ◽  
Cerebral Perfusion Pressure ◽  
Cerebral Perfusion ◽  
Perfusion Pressure ◽  
Craniocerebral Trauma ◽  
The Other ◽  
Increased Intracranial Pressure ◽  
Craniocerebral Injuries

In a considerable number of cases, many polytraumatized patients in a state of hemorrhagic shock, who require immediate surgical treatment, there is craniocerebral trauma. Ketamine is viewed, on one hand, as an appropriate induction anesthetic, due to its circulatory stimulating effect in treating shock victims, and, on the other hand, it is rejected for treating patients with craniocerebral injuries, because of the danger of possible increase in intracranial pressure (ICP). Therefore, we examined the effects of ketamine on ICP and calculated the cerebral perfusion pressure, using test animals in a state of hemorrhagic shock and a space occupying intracranial process.

Cerebral perfusion pressure and intracranial pressure are not surrogates for brain tissue oxygenation in traumatic brain injury

2012 ◽  
Vol 123 (6) ◽  
pp. 1255-1260 ◽  
Author(s):  
Evert A. Eriksson ◽  
Jeffrey F. Barletta ◽  
Bryan E. Figueroa ◽  
Bruce W. Bonnell ◽  
Wayne E. Vanderkolk ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Intracranial Pressure ◽  
Brain Tissue ◽  
Cerebral Perfusion Pressure ◽  
Cerebral Perfusion ◽  
Tissue Oxygenation ◽  
Perfusion Pressure ◽  
Brain Tissue Oxygenation
Sign in / Sign up

Export Citation Format

Share Document