Raised intracranial pressure Flashcards

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1
Q

Pathophysiology

A

Normal ICP is 7-15 mmHg in adults in supine position

Cerebral perfusion pressure is net pressure gradient causing cerebral blood flow to brain

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2
Q

Causes

A

IIH

Traumatic head injuries

Infection (meningitis)

Tumours

Hydrocephalus

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3
Q

Features

A

Headache

Vomiting

Reduced level of consciousness

Cushing’s triad

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4
Q

Cushing’s triad

A

Widening pulse pressure

Bradycardia

Irregular breathing

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5
Q

Investigations

A

CT/MRI key to investigate underlying cause

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6
Q

Monitoring

A

Invasive ICP

Catheter placed into lateral ventricles of brain to monitor pressure

May also be used to collect CSF sample and drain small amounts of CSF to reduce pressure

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7
Q

Management

A

Investigate and treat underlying cause

Head elevation to 30’

IV mannitol

Controlled hyperventilation

Removal of CSF

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8
Q

Controlled hyperventilation

A

Aim to reduce pCO2 –> vasoconstruction of the cerebral arteries –> reduce ICP

Leads to rapid, temporary lowering if ICP

Caution needed as may reduce blood flow to already ischaemic parts of the brain

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9
Q

Techniques for removal of CSF

A

Drain from intraventricular monitor

Repeated LP

Ventriculoperitoneal shunt (for hydrocephalus)

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