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Intracranial hypertension (IH), also called increased ICP (IICP) or raised intracranial pressure (RICP), refers to elevated pressure in the cranium. 20–25 mmHg is the upper limit of normal at which treatment is necessary, though it is common to use 15 mmHg as the threshold for beginning treatment.
Idiopathic intracranial hypertension (IIH), previously known as pseudotumor cerebri and benign intracranial hypertension, is a condition characterized by increased intracranial pressure (pressure around the brain) without a detectable cause. [2] The main symptoms are headache, vision problems, ringing in the ears, and shoulder pain.
It can cause complications such as vision impairment due to intracranial pressure , permanent neurological problems, reversible neurological problems, seizures, stroke, and death. [1] However, aside from a few Level I trauma centers, ICP monitoring is rarely a part of the clinical management of patients with these conditions.
Cushing reflex (also referred to as the vasopressor response, the Cushing effect, the Cushing reaction, the Cushing phenomenon, the Cushing response, or Cushing's Law) is a physiological nervous system response to increased intracranial pressure (ICP) that results in Cushing's triad of increased blood pressure, irregular breathing, and bradycardia. [1]
Cerebral perfusion pressure, or CPP, is the net pressure gradient causing cerebral blood flow to the brain (brain perfusion).It must be maintained within narrow limits because too little pressure could cause brain tissue to become ischemic (having inadequate blood flow), and too much could raise intracranial pressure (ICP).
Patients may have a history of loss of consciousness but they recover and do not relapse. Clinical onset occurs over hours. Complications include focal neurologic deficits depending on the site of hematoma and brain injury, increased intracranial pressure leading to herniation of brain and ischemia due to reduced blood supply and seizures.
Excessive reduction in blood pressure can precipitate coronary, cerebral, or kidney ischemia and, possibly, infarction. [citation needed] A hypertensive emergency is not based solely on an absolute level of blood pressure, but also on a patient's baseline blood pressure before the hypertensive crisis occurs.
If the noxious stimuli cannot be identified or the systolic blood pressure remains above 150 mmHg, then pharmacologic treatment may be needed. [27] In this situation, the aim is to decrease the elevated intracranial pressure until further studies can identify the cause. [28] Pharmacologic treatment will include antihypertensive medications.