Management of intracranial hypertension.
Loading...
Date
2009-05
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Raised intracranial pressure (ICP) is a life threatening condition that is common to many neurological and non-neurological
illnesses. Unless recognized and treated early it may cause secondary brain injury due to reduced cerebral perfusion
pressure (CPP), and progress to brain herniation and death. Management of raised ICP includes care of airway, ventilation
and oxygenation, adequate sedation and analgesia, neutral neck position, head end elevation by 200 -300, and short-term
hyperventilation (to achieve PCO2 32- 35 mm Hg) and hyperosmolar therapy (mannitol or hypertonic saline) in critically
raised ICP. Barbiturate coma, moderate hypothermia and surgical decompression may be helpful in refractory cases.
Therapies aimed directly at keeping ICP <20 mmHg have resulted in improved survival and neurological outcome.
Emerging evidence suggests that cerebral perfusion pressure targeted therapy may offer better outcome than ICP targeted
therapies.
Description
Keywords
Intracranial pressure, Children, Traumatic brain injury, Cerebral perfusion pressure, Hyperosmolar therapy
Citation
Singhi Sunit C, Tiwari Lokesh. Management of intracranial hypertension. Indian Journal of Pediatrics. 2009 May; 76(5): 519-529.