E-Note for Adult
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|INTRACRANIAL PRESSURE (ICP)
Normally is between 2-12 mmHg.
Raised ICP in the range 15-40 mmHg, while not harmful by itself, can rapidly result in secondary damage, either by precipitously decreasing cerebral perfusion or by associated shifts of brain tissue that damage the upper brainstem.
When the difference between blood pressure in the major cerebral arteries & ICP ("Cerebral perfusion pressure or CPP) is < 40-60 mmHg, raised ICP becomes detrimental to nerve cells; therapy is therefore directed toward maintaing perfusion above this range.
Usual CSF lateral decubitus pressure 6-13 mmHg (9-18 cm H2O); sitting position CSF pressure 40 cm H2O.
The most important secondary nervous system complication of head injury is raid ICP arising from the added volume of contusions, hematomas, & the progressive edema surrounding them.
DIENCEPHALIC HERNIATION (SUPRATENTORIAL MEDIAL LESION)
UNCAL HERNIATION (LATERAL LESION)
TONSILLAR HERNIATION (INFERIOR PORTION OF CEREBELLUM)