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Neurology > Raised ICP > Flashcards

Raised ICP Flashcards

1
Q

What is the normal range for ICP?

A

5-15 mmHg

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2
Q

What is CPP?

A

Cerebral perfucsion pressure

The net pressure gradient causing cerebral blood flow to the brain

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3
Q

How is CPP calculated?

A

CPP = MAP - ICP

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4
Q

What is the Monro-Kellie doctrine?

A

Relationship between contents of the cranium and ICP

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5
Q

What are the major components found in the cranium?

A

Brain tissue
CSF
Blood

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6
Q

What happens if the volume of one of these components rises?

A

Causes a rise in ICP

So one of the other components needs to decrease in volume

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7
Q

What are the main compensatory mechanisms for raised ICP?

A

Increased blood drainage

Increased CSF drainage

Brain herniation

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8
Q

What can cause raised ICP?

A 
Idiopathic intracranial hypertension 
Traumatic head injuries 
Infection 
Tumours
Hydrocephalus
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9
Q

What are features of raised ICP?

A

Headache - worse in morning
Vomiting
Reduced consciousness
Papilloedema

Cushing’s triad

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10
Q

What is Cushing’s triad?

A

Widened pulse pressure
Bradycardia
Irregular breathing

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11
Q

How is raised ICP investigated?

A

Neuro imaging

Invasive ICP monitoring

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12
Q

How is ICP monitored?

A

Subarachnoid bolt

Epidural bolt

External ventricular drain

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13
Q

How is raised ICP managed?

A

Find underlying cause

Head elevation to 30 degrees

IV mannitol

Controlled hyperventilation

CSF drainage

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14
Q

How does controlled hyperventilation work?

A

Reduce pCO2 -> vasoconstriction of cerebral arteries -> reduced ICP

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15
Q

How is CSF drained?

A

Catheter placed into lateral ventricles

Repeated LP

Ventriculoperitoneal shunt

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16
Q

What is idiopathic intracranial hypertension?

A

Condition where there is raised ICP without a cause

17
Q

What are risk factors for idiopathic intracranial hypertension?

A

Obesity
Female sex
Pregnancy

Drugs

  • COCP
  • steroids
  • lithium
18
Q

What are features of idiopathic intracranial hypertension?

A

Headache
Blurred vision
Papilloedema
Enlarged blindspot

19
Q

How is idiopathic intracranial hypertension managed?

A

Weight loss
Diuretics
Topiramate
Repeated LP

20
Q

What is hydrocephalus?

A

Accumulation of CSF in the cerebral ventricles

21
Q

How can hydrocephalus be classified?

A

Obstructive

Communicating

22
Q

What is obstructive hydrocephalus?

A

Blockage to natural ventricular drainage system

23
Q

What can cause obstructive hydrocephalus?

A

Tumour
Cysts
Congenital

24
Q

What is communicating hydrocephalus?

A

Reduced absorbance of CSF by arachnoid villi

25
Q

What can cause communicating hydrocephalus?

A

Infective meningitis
SAH
Congenital
Normal pressure hydrocephalus

26
Q

What is normal pressure hydrocephalus?

A

Ventricular dilatation in the absence of raised CSF pressure

27
Q

What are teh features of normal pressure hydrocephalus?

A

Parkinsonin gait
Urinary incontinence
Dementia

28
Q

How is normal pressure hydrocephalus managed?

A

CSF shunt

29
Q

What are features of hydrocephalus?

A

N+V
Morning headache
Altered GCS
Blurred vision

30
Q

How is suspected hydrocephalus investigated?

A

CT brain

LP

31
Q

What is seen on a CT head in hydrocephalus?

A

Enlarged ventricles

Loss of sulcal gyral pattern

CSF exudation from ventricles = hypodensity around ventricular margins

32
Q

How is hydrocephalus managed?

A

Insertion of external ventricular drain

Treat underlying cause

Neurology (23 decks)

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