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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]
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).
[10] [13] Too much blood (a clinical condition of a normal homeostatic response of hyperemia) [1] can raise intracranial pressure (ICP), which can compress and damage delicate brain tissue. Too little blood flow ( ischemia ) results if blood flow to the brain is below 18 to 20 ml per 100 g per minute, and tissue death occurs if flow dips below ...
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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]
Thus, if there is a question of papilledema on fundoscopic examination or if the optic disc cannot be adequately visualized, ultrasound can be used to rapidly assess for increased intracranial pressure and help direct further evaluation and intervention. Unilateral papilledema can suggest a disease in the eye itself, such as an optic nerve glioma.