Raised ICP

Question 1

What is the normal ICP?

Answer 1

Between 5-13 mmHg

Question 2

What are the causes of raised ICP?

Answer 2

Increased CSF
Focal lesion in the brain (SOL)
Diffuse lesion in the brain e.g. oedema, haemorrhage
Increased venous volume
Physiological (hypoxia, hypercapnia, pain)

Question 3

What is bushings triad and what is it a sign of?

Answer 3

A sign of raised ICP

Hypertension, Bradycardia and widening pulse pressure

Question 4

If someone presents with a blown pupil or a drop in heart rate what drug would you give them?

Answer 4

Mannitol

Question 5

4 clinical signs of raised ICP

Answer 5

Papilloedema
Headache
N&V
Neck stiffness

Question 6

How does a subfalcine herniation present?

Answer 6

Weakness and sensory loss in the leg

Question 7

What artery is there compression of in subfalcine herniations?

Answer 7

Anterior cerebral artery

Question 8

In tectorial herniation what is compressed?

Answer 8

Ipsilateral CNIII and its primary parasympathetic fibres

Question 9

What is cerebellar herniation?

Answer 9

Displacement of cerebellar tonsils through the foramen magnum

Question 10

Why is cerebellar herniation life-threatening?

Answer 10

Causes brainstem compression and compromises vital respiratory centres in medullar oblongata

Question 11

Define Transcalvarial herniation

Answer 11

A swollen brain will herniate through any defect in the dura and skull

Question 12

An increasing number of what can lead to multi-infarct dementia?

Answer 12

Lacunes (less than 15mm infarcts)

Question 13

Hyaline atherosclerosis makes the vessels more likely to which two things?

Answer 13

Occlusion

Rupture

Question 14

TRUE/FALSE

Stiffer arteries require a higher blood pressure for perfusion

Answer 14

TRUE

Question 15

Why do those with hypertensive encephalopathy show symptoms of increased ICP

Answer 15

Upper level of auto regulatory mechanism is saturated

BBB incapable of resisting movement of plasma proteins like albumin and water