Raised ICP Flashcards
What are the risk factors for idiopathic intracranial hypertension?
Obesity
Female sex
Pregnancy
Drugs
- COCP
- Steroids
- Tetracyclines
- Retinoids
- Lithium
What are the features of idiopathic intracranial hypertension?
Headache
Blurred vision
Papilloedema
Enlarged blind spot
Sixth nerve palsy
What is the management of idiopathic intracranial hypertension?
Weight loss
Acetazolamide
Topiramate
What are the causes of raised ICP?
Traumatic brain injury
CNS tumours
Hydrocephalus
Hypertension
Meningitis
Encephalitis
Venous sinus thrombosis
What are the features of raised ICP?
Cushing’s triad - late stage ICP
- Bradycardia
- hypertension
- irregular respirations
Headache
Nausea
Vomiting
Confusion
Papilloedema
Altered consciousness
Blown pupil
What investigations are used to diagnose raised ICP?
CT head - identify causes such as tumours or haemorrhage
Fundoscopy - papilloedema
LP - may be used if infection considered
ICP monitoring (via intraventricular catheter)
What are the maangement principles of raised ICP?
Treating underlying cause
Reducing ICP
Maintaining cerebral perfusion
How can ICP be reduced?
Elevate head
Mannitol
Dexamethasone
Hyperventilation
Surgical decompression
What are the complications of mannitol treatment?
Hypotension
Rebound increase in ICP
Volume overload
Hyponatraemia
