Raised ICP Initial Assessment Flashcards
What can cause raised ICP?
- CEREBRAL OEDEMA - Space occupying lesions
What are the 3 types of cerebral oedema?
Vasogenic Cytotoxic Interstitial
What causes vasogenic oedema?
From blood vessels - Tumour - Trauma - Ischaemia - Infection - Increased capillary permeability
What causes cytotoxic oedema?
Cell death Brain abscess
What causes interstitial oedema?
Obstructive hydrocephalus - Blockage of normal CSF reabsorption
Symptoms of a raised ICP?
Headache Low consciousness Vomiting Seizures COMA
What are the signs of a raised ICP?
Cushing’s Triad
What is Cushing’s Triad of Raised ICP?
Elevated BP Bradycardia Irregular breathing - Cheyne Stokes respiration
Tests with raised ICP?
Emergency CT head Consider LP if thought to be safe
Blood tests?
U&Es FBC Glucose Serum osmolarity - Treat this Clotting screen Cultures
Emergency treatment?
DrABCDE URGENT CRANIOTOMY OR BURR HOLE - If focal cause such as haematoma
What other management should be done?
Elevate the head Hyperventilate to cause cerebral vasoconstriction Restrict fluid levels
What can be a complication of raised ICP?
Herniation
What are the three herniation syndromes?
Uncal Coning Subfalcian
What is an uncal herniation?
The inferiomedial temporal lobe puts pressure on the midbrain
Shown by numba 3
What is a subfalcine herniation?
The cingulate gyrus is pushed away from the lesion and forced underneath the falx
What is coning?
The cerebellar tonsils herniate through the foramen magnum
