Raised ICP

Question 1

List 8 different causes of raised ICP

Answer 1

Idiopathic intracranial HTN
CNS inflammation, infection, abscess
SOL: haemorrhage, aneurysm, tumour
Elevated venous pressures, e.g. HF
Increased CSF
Metabolic disturbance: hyponatraemia, hepatic encephalopathy
Epilepsy/ seizures

Question 2

What symptoms are experienced in raised ICP?

Answer 2

Headache: worse when waking, coughing or moving head
Altered mental state: drowsiness to coma
Lethargy, irritability, slow decision making + abnormal social behaviour.
Blurred vision/ diplopia
Vomiting

Question 3

What signs may be seen in raised ICP?

Answer 3

Cushing’s triad: irregular RR, widening pulse pressure + bradycardia
Reduced levels of consciousness
Papilledema
Psychiatric changes

Question 4

What investigations should be performed for raised ICP?

Answer 4

CT/ MRI: to determine any underlying lesion.

Check + monitor blood glucose, renal function, electrolytes + osmolality.

Question 5

What happens when ICP reaches a certain point?

Answer 5

The high BP causes reflex bradycardia + brainstem compromise resulting in irregular RR
(Cushing triad: bradycardia, HTN + irregular RR)