Raised ICP

Question 1

What are the causes of a raised ICP in a child?

Answer 1

Meningoencephalitis, head injury, subdural or extradural hematoma, tumours, thrombosis.

Question 2

What is this a presentation of?
Irritable, drowsy, headache, diplopia, vomiting, tense fontanelle, reduced responsiveness, dilated ipsilateral pupil, abnormal posturing, Cushing’s triad (bradycardia, hypertension, abnormal breathing).

Answer 2

Raised ICP

Question 3

What is the scoring method for determining severity of a raised ICP in those under and over 4 years of age, and when should you intubate?

Answer 3

1. <4 - Children’s Coma Scale
2. > 4 - GCS
3. Under 8

Question 4

What is the management of a raised ICP?

Answer 4

1. ABCDE, oxygen, treat hypoglycaemia.
2. intubate
3. mannitol
4. dexamethasone
5. fluid restriction and diuresis, avoid hypovolaemia