Intracranial Pressure IV


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HTS can also be used to treat hyponatraemia, which untreated can worsen brain oedema. Ensure that serum sodium is not increased too rapidly. Mannitol will cause an initial plasma expansion that should improve CBF. However, the BBB becomes permeable to mannitol and it may worsen vasogenic oedema. Still, it may be useful to break a plateau wave of increased ICP. Paradoxically, this may increase oxygenation of the brain because of the reduction in ICP. This should be done only in a controlled neurocritical care setting.

For resuscitation and stabilisation, it is best to aim for a PaCO 2 of 4 - 4. Remember to check the arterial blood gas; preferably also use end tidal CO 2 monitoring. Current evidence from clinical trials does not support a clear benefit of hypothermia in head injury. However, for individual patients this may be worth trying. The evidence for benefit is stronger for patients who have had a cardiac arrest and for neonatal hypoxic ischaemia. Neurological deficit secondary to surrounding oedema often responds within 72 hours. However, the effect diminishes over time.

Occasionally CSF drainage can be helpful even when the ventricles are small, as in trauma. It increases cranial volume and so reduces ICP. However, whether this benefits clinical outcome remains controversial. Patients with raised ICP are likely to have their long-term care guided by a neurologist or a neurosurgeon, depending on the nature of the underlying pathology. As a general physician, one should be vigilant about recognising signs of raised pressure, in particular in patients with implanted devices such as CSF shunts that may be malfunctioning.

A close working relationship with the specialist, allowing for concerns to be discussed timeously, is advantageous. Dunn LT. Raised intracranial pressure. J Neurol Neurosurg Psychiatry ;i Pickard JD. Management of raised intracranial pressure.

Reducing intracranial pressure in patients with traumatic brain injury

J Neurol Neurosurg Psychiatry ; Rangel CL. Management of intracranial hypertension. Neurol Clin ; Indian J Paediatr ; Lindsay K. Bone I: Neurology and Neurosurgery Illustrated. UK: Churchill Livingstone, Jacks AS. Spontaneous retinal venous pulsation: Aetiology and significance. Holdgate A. Perils and pitfalls of lumbar puncture in the emergency department.

Emergency Medicine Fremantle, WA ; Linden CH. Cranial computed tomography before lumbar puncture. Arch Intern Med ; Oliver WJ. Fatal lumbar puncture: Fact versus fiction — an approach to a clinical dilemma. Pediatrics ;e Citerio G. Intracranial pressure. Intensive Care Med ; Raised intracranial pressure: What it is and how to recognise it This article presents an approach to raised intracranial pressure ICP constructed in a question-answer fashion.

What is raised intracranial pressure? Representation of the cranial constituents. For resuscitation and stabilisation, it is best to aim for a PaCO 2 of 4 - 4. Remember to check the arterial blood gas; preferably also use end tidal CO 2 monitoring. Current evidence from clinical trials does not support a clear benefit of hypothermia in head injury.


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  • Management of intracranial pressure.

However, for individual patients this may be worth trying. The evidence for benefit is stronger for patients who have had a cardiac arrest and for neonatal hypoxic ischaemia. Neurological deficit secondary to surrounding oedema often responds within 72 hours. However, the effect diminishes over time. Occasionally CSF drainage can be helpful even when the ventricles are small, as in trauma. It increases cranial volume and so reduces ICP. However, whether this benefits clinical outcome remains controversial.

Increased Intracranial Pressure - For Nurses & Nursing Students!

Patients with raised ICP are likely to have their long-term care guided by a neurologist or a neurosurgeon, depending on the nature of the underlying pathology. As a general physician, one should be vigilant about recognising signs of raised pressure, in particular in patients with implanted devices such as CSF shunts that may be malfunctioning. A close working relationship with the specialist, allowing for concerns to be discussed timeously, is advantageous.

Dunn LT. Raised intracranial pressure.

Management of intracranial pressure — Mayo Clinic

J Neurol Neurosurg Psychiatry ;i Pickard JD. Management of raised intracranial pressure. J Neurol Neurosurg Psychiatry ; Rangel CL. Management of intracranial hypertension.

Recommended ICP monitoring method

Neurol Clin ; Indian J Paediatr ; Lindsay K. Bone I: Neurology and Neurosurgery Illustrated. UK: Churchill Livingstone, Jacks AS. Spontaneous retinal venous pulsation: Aetiology and significance. Holdgate A.

scavuntolojob.tk Perils and pitfalls of lumbar puncture in the emergency department. Emergency Medicine Fremantle, WA ; Linden CH. Cranial computed tomography before lumbar puncture. Arch Intern Med ; Oliver WJ. Fatal lumbar puncture: Fact versus fiction — an approach to a clinical dilemma. Pediatrics ;e Citerio G. Intracranial pressure.

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