ICP Inter-cranial pressure

Question 0

Late sign raised ICP

Answer 0

Unresponsive 
Cushings's reflex
- Hypertension 
- widening pulse pressure
- bradycardia

Cheyene-Stroke
Abnormal posturing

Question 1

Early signs of ICP

Answer 1

Altered level of conscious

• restless, agitated, confusion
• drowsiness

Headache
Urine output >300ml/hr
N &V
Pupil change
Seizure

Question 2

Mx ICP

Answer 2

Aim
- Prevent secondary injury
- Maintain / optimise cerebral perfusion
- ICP < 20mmHg
LEFT UNTREATED ^ICP herniation of brain tissue & death

Question 3

Reducing ICP

Answer 3

• Osmotic diuretic - Mannitol 20% (0.25-1g/kg OR Hypertonic saline
• Drainage of CSF (external ventricular drain)
• surgical decompression - craniectomy