raised ICP? Flashcards
1
Q
what is raised ICP?
A
● The volume inside the cranium is fixed so any increase in the volume can lead to raised ICP
● This can be mass effect, oedema or obstruction to fluid outflow
2
Q
what is normal ICP in adults?
A
● Normal ICP in adults is 7-15mmHg
3
Q
causes of raised ICP?
A
o Idiopathic intracranial hypertension o Traumatic head injuries o Infection o Tumours o Hydrocephalus
4
Q
presneting symptoms of raised ICP?
A
● Headache: worse on coughing and leaning forwards, worse in morning ● Vomiting ● Reduced levels of consciousness. ● History of trauma ● Poor vision
5
Q
signs of raised ICP on physical examination?
A
● Altered GCS ● Cushing’s triad – ● Cheyne-Stokes respiration ● Pupil changes – constriction first, later dilatation ● Reduced visual acuity ● Peripheral visual field loss ● Papilloedema
6
Q
what is cushings triad?
A
o Widening pulse pressure
o Bradycardia
o Irregular breathing
7
Q
what is cheyenne stokes respiration?
A
progressively deeper and sometimes faster breathing followed by a gradual decrease that results in a temporary stop in breathing
8
Q
investigations into raised ICP?
A
● Neuroimaging o CT/MRI ● Invasive ICP monitoring ● U&E, FBC, LFT, glucose, serum osmolality, clotting, blood culture ● tox screen ● consider if LP is safe.
