Intracranial Hypertension Resident Survival Guide
| Intracranial Hypertension Resident Survival Guide Microchapters |
|---|
| Overview |
| Causes |
| Diagnosis |
| Treatment |
| Do's |
| Don'ts |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sabeeh Islam, MBBS[2]
Synonyms and keywords:
Overview
Causes
Life Threatening Causes
Life-threatening causes include conditions that may result in death or permanent disability within 24 hours if left untreated. If intracranial hypertension left untreated, may cause:
- Transtentorial herniation
- Respiratory depression
- Coma
- Brain death
Common Causes
- Aneurysm
- Arnold-chiari malformation
- Behçet's disease
- Brain tumor
- Cerebral edema
- Cerebral venous sinus thrombosis
- Choroid plexus tumor
- Chronic kidney disease
- Colloid cyst of third ventricle
- Contusions
- Crouzon craniofacial dysostosis
- Cushing's syndrome
- Dural arteriovenous fistula
- Encephalitis
- Epidural haemorrhage
- Epidural hematoma
- Erdheim-chester disease
- Excess cerebrospinal fluid
- Head trauma
- Hydrocephalus
- Hypertensive brain hemorrhage
- Hypertensive encephalopathy
- Idiopathic intracranial hypertension
- Intracranial granuloma
- Intracranial haemorrhage
- Intraventricular hemorrhage
- Meningioma
- Meningitis
- Meningoencephalitis
- Obstruction of superior mediastinal veins
- Obstruction of jugular veins
- Status epilepticus
- Stroke
- Subarachnoid haemorrhage
- Subdural haemorrhage
- Subdural hematoma
- Vasculitis
- Venous sinus thrombosis
Diagnosis and Treatment
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Do's
- Maintain oxygen
- Head elevation
- Hyperventilation to achieve a PaCO2 of 26-30 mmHg
- Osmotic diuresis with intravenous mannitol and Lasix
- Appropriate sedation, if patient requires intubation. Propofol is considered to be the preferred agent.
- Therapeutic hypothermia to achieve a low metabolic state
- Appropriate choice of fluids to achieve euvolemic state. Avoid hypotonic agents
- Allow permissive hypertension. Treat hypertension only when CPP >120 mmHg and ICP >20 mmHg
- Seizure prophylaxis with anticonvulsant therapy.