Increased intracranial Pressure Flashcards
Which measure can be taken to lower intracranial pressure (ICP)?
a) Elevation of the head of the bed to greater than 30 degrees
b) Keeping the neck midline
c) Hyperventilation to lower pCO2 to around 30 mm Hg
d) All of the above
D
Which osmotic agent can be used to decrease cerebral edema and lower ICP?
a) Acetazolamide
b) Mannitol
c) Glyburide
d) Barbiturates
B
Which condition warrants the use of steroids to reduce ICP?
a) Traumatic brain injury
b) Intracranial neoplastic tumors
c) Idiopathic intracranial hypertension
d) Chronic idiopathic hypertension
B
What is the primary mechanism of action of mannitol in lowering ICP?
a) Decreasing blood viscosity
b) Decreasing blood volume
c) Decreasing CSF production
d) Increasing osmotic gradient across blood vessels
A
Mannitol, when administered intravenously, works by increasing the osmotic pressure in the blood. This increased osmotic pressure draws water out of brain tissue, reducing brain swelling and decreasing the overall volume of blood in the cerebral circulation. As a result, blood viscosity decreases, improving blood flow and reducing resistance.
Which medication can be used to decrease the production of CSF and treat idiopathic intracranial hypertension?
a) Mannitol
b) Acetazolamide
c) Glyburide
d) Barbiturates
B
Besides diagnostic purposes, how does lumbar puncture contribute to lowering ICP?
a) By reducing cerebral edema
b) By draining CSF
c) By inhibiting SUR1 receptors
d) By increasing blood viscosity
B
What is the purpose of an EVD (external ventricular drain) in the management of elevated ICP?
a) Monitoring ICP
b) Draining CSF
c) Inhibiting CSF production
d) Lowering blood viscosity
When is a decompressive craniectomy considered in the management of ICP?
a) As an initial treatment option
b) After all other measures have failed
c) In cases of chronic idiopathic hypertension
d) As a prophylactic measure
B
Which measure can be taken to facilitate venous drainage from the head and help lower intracranial pressure (ICP)?
a) Hypercarbia
b) Hypocarbia
c) Keeping the neck midline
d) Osmotic agents
C
What is the recommended target pCO2 level when using hyperventilation to transiently lower ICP?
a) 20 mm Hg
b) 30 mm Hg
c) 40 mm Hg
d) 50 mm Hg
30 mm Hg
(26-30)
What is the potential risk associated with lumbar punctures when ICP is raised due to mass effect?
a) Herniation
b) Bleeding
c) Infection
d) Seizures
A
In refractory cases of elevated ICP, which therapeutic approach involves reducing the body temperature to 32-35 degrees Celsius?
a) Hyperventilation
b) Osmotic agents
c) Therapeutic hypothermia
d) Carbonic anhydrase inhibitors
C
