Raised intracranial Pressure

Question 1

What is the normal ICP?

Answer 1

7-15 mmHg

Question 2

What are the causes of raised ICP?

Answer 2

Idiopathic intracranial hypertension,
Traumatic head injuries,
Infection eg, meningitis,
Tumours,
Hydrocephalus

Question 3

Presentation of raised ICP?

Answer 3

Headache,
Vomiting,
Reduced consciousness,
Papilloedema,
Cushing’s triad - Widening pulse pressure, bradycardia, irregular breathing

Question 4

What are the investigations for raised ICP?

Answer 4

Neuroimaging (Investigating underlying cause),
Invasive ICP monitoring (cath placed into lateral ventricles)

Question 5

Management of raised ICP?

Answer 5

Head elevation to 30 degrees,
IV mannitol used as osmotic diuretic,
Controlled hyperventilation - Reduced CO2 which causes vasoconstriction of cerebral arteries and thus lowers ICP.
Removal of CSF - Drain, repeated LPs (idiopathic intracranial hypertension), Ventriculoperioneal shunt (hydrocephalus)