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Principles and Management of Alterations in Intracranial Pressure 

Principles and Management of Alterations in Intracranial Pressure
Principles and Management of Alterations in Intracranial Pressure

Heidi T. Woessner

and William D. Freeman

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date: 25 July 2021

Intracranial pressure (ICP) is a reflection of the total volume inside the skull. Normal ICP is 0 to 10 mm Hg. Intracranial hypertension is defined as sustained ICP of more than 20 mm Hg. Increased ICP may lead to a reduction of cerebral perfusion pressure (CPP), a shift of brain tissue, and, as a result, secondary brainstem injury. Monitoring of increased ICP provides the opportunity to effectively treat damaging pressure waves and is needed to prevent irreversible damage. The 3 constituents of intracranial volume are the brain, cerebral spinal fluid (CSF), and blood. These elements sit within the fixed volume of the skull. If one of these 3 components increases in volume, the other 2 must compensate by reducing volume. If they cannot compensate, ICP increases.

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