Condition- Raised ICP

Question 1

What is the normal ICP?

Answer 1

0-10mmHg

Question 2

List some causes of raised ICP

Answer 2

• Space Occupying lesions:
  
  • Tumour
  • Infection- meningitis, encephalitis
  • Haemorrhage
• Hydrocephalus
• Cerebral Oedema
• Status epilepticus
• Trauma

Question 3

List some of the presenting symptoms of Raised ICP

Answer 3

• Headache: worse in the mornings and worse on leaning over and coughing
• Altered GCS: Drowsiness and vomitting = admit patient
• Poor Vision

Question 4

What is the Cushing’s response to RICP?

Answer 4

• Falling pulse and rising BP (cushing’s response) + Irregular breathing

Question 5

Descibe the sort of breathing that might be seen in patient with RICP

Answer 5

Cheyne-Stokes respiration – progressively deeper and sometimes faster breathing followed by a gradual decrease that results in a temporary stop in breathing - cycle repeats

Question 6

What changes might you seen when testing the eyes in a neuro examination of someone with RICP?

Answer 6

EYES:

• Pupil changes – constriction first, later dilatation
• Reduced visual acuity
• Peripheral visual field loss
• Papilloedema – unreliable sign but venous pulsation at the disc may be absent

Question 7

What would be your initial investigation in someone with suspected RICP? Which investigation must you avoid?

Answer 7

CT HEAD URGENT

Question 8

Which investgation must you avoid in someone with RICP and why?

Answer 8

Must avoid LP

Can lead to uncal herniation