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Intracranial pressure (ICP) is the pressure exerted by fluids such as cerebrospinal fluid (CSF) inside the skull and on the brain tissue. ICP is measured in millimeters of mercury and at rest, is normally 7–15 mmHg for a supine adult. This equals to 9–20 cmH 2 O, which is a common scale used in lumbar punctures. [1]
Under normal conditions, regular movements such as leaning forward, normal heartbeat and breathing can cause changes to the ICP. Intracranial monitoring accounts for this by averaging measurements over 30 minutes in non-comatose patients. Readings between 7-15mmHg are considered normal in an adult, 3-7mmHg in children, and 1.4-6mmHg in infants. [4]
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.
Under normal circumstances a MAP between 60 and 160 mmHg and ICP about 10 mmHg (CPP of 50-150 mmHg) sufficient blood flow can be maintained with autoregulation. [ 1 ] [ 2 ] Although the classic 'autoregulation curve' suggests that CBF is fully stable between these blood pressure values (known also as the limits of autoregulation), in practice ...
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.
Papilledema or papilloedema is optic disc swelling that is caused by increased intracranial pressure due to any cause. [1] The swelling is usually bilateral and can occur over a period of hours to weeks. [2] Unilateral presentation is extremely rare. In intracranial hypertension, the optic disc swelling most commonly occurs bilaterally.
Presence of midline shift is an indication for neurosurgeons to take measures to monitor and control ICP. [1] Immediate surgery may be indicated when there is a midline shift of over 5 mm. [3] [4] The sign can be caused by conditions including traumatic brain injury, [1] stroke, hematoma, or birth deformity that leads to a raised intracranial ...
Central neurogenic hyperventilation (CNH) is an abnormal pattern of breathing characterized by deep and rapid breaths at a rate of at least 25 breaths per minute. Increasing irregularity of this respiratory rate generally is a sign that the patient will enter into coma.