- 1 On being a patient
- 2 Modern medicine: foundations, achievements, and limitations
- 3 Global patterns of disease and medical practice
- 4 Cell biology
- 5 Immunological mechanisms
- 6 Principles of clinical oncology
- 7 Infection
- 8 Sexually transmitted diseases and sexual health
- 9 Chemical and physical injuries and environmental factors and disease
- 10 Clinical pharmacology
- 11 Nutrition
- 12 Metabolic disorders
- 13 Endocrine disorders
- 14 Medical disorders in pregnancy
- 15 Gastroenterological disorders
- 16 Cardiovascular disorders
- 17 Critical care medicine
- 17.1 Cardiac arrest
- 17.2 Anaphylaxis
- 17.3 The clinical approach to the patient who is very ill
- 17.4 Circulation and circulatory support in the critically ill
- 17.5 Acute respiratory failure
- 17.6 Management of raised intracranial pressure
- 17.7 Sedation and analgesia in the critically ill
- 17.8 Discontinuing treatment of the critically ill patient
- 17.9 Brainstem death and organ donation
- 18 Respiratory disorders
- 19 Rheumatological disorders
- 20 Disorders of the skeleton
- 21 Disorders of the kidney and urinary tract
- 22 Disorders of the blood
- 23 Disorders of the skin
- 24 Neurological disorders
- 25 The eye
- 26 Psychiatry and drug related problems
- 27 Forensic medicine
- 28 Sports medicine
- 29 Geratology
- 30 Pain
- 31 Palliative medicine
- 32 Biochemistry in medicine
- 33 Acute medicine
(p. 3147) Management of raised intracranial pressure
- Chapter:
- (p. 3147) Management of raised intracranial pressure
- Author(s):
David K. Menon
- DOI:
- 10.1093/med/9780199204854.003.1706_update_001
Update:
Indications for decompressive craniectomy in traumatic brain injury.
Normal intracranial pressure (ICP) is between 5 and 15 mmHg in supine subjects. Intracranial hypertension (ICP >20 mmHg) is common in many central nervous system diseases and in fatal cases is often the immediate cause of death.
Aetiology and pathogenesis—increases in intracranial volume and hence—given the rigid skull—ICP may be the consequence of (1) brain oedema, (2) increased cerebral blood volume, (3) hydrocephalus, and (4) space-occupying lesions. Brain perfusion depends on the difference between mean arterial pressure and ICP, termed cerebral perfusion pressure (CPP). The normal brain autoregulates cerebral blood flow down to a lower limit of CPP of about 50 mmHg in healthy subjects, and perhaps 60 to 70 mmHg in disease. CPP reduction to below these values results in cerebral ischaemia....
Access to the complete content on Oxford Medicine Online requires a subscription or purchase. Public users are able to search the site and view the abstracts for each book and chapter without a subscription.
Please subscribe or login to access full text content.
If you have purchased a print title that contains an access token, please see the token for information about how to register your code.
For questions on access or troubleshooting, please check our FAQs, and if you can't find the answer there, please contact us.
- 1 On being a patient
- 2 Modern medicine: foundations, achievements, and limitations
- 3 Global patterns of disease and medical practice
- 4 Cell biology
- 5 Immunological mechanisms
- 6 Principles of clinical oncology
- 7 Infection
- 8 Sexually transmitted diseases and sexual health
- 9 Chemical and physical injuries and environmental factors and disease
- 10 Clinical pharmacology
- 11 Nutrition
- 12 Metabolic disorders
- 13 Endocrine disorders
- 14 Medical disorders in pregnancy
- 15 Gastroenterological disorders
- 16 Cardiovascular disorders
- 17 Critical care medicine
- 17.1 Cardiac arrest
- 17.2 Anaphylaxis
- 17.3 The clinical approach to the patient who is very ill
- 17.4 Circulation and circulatory support in the critically ill
- 17.5 Acute respiratory failure
- 17.6 Management of raised intracranial pressure
- 17.7 Sedation and analgesia in the critically ill
- 17.8 Discontinuing treatment of the critically ill patient
- 17.9 Brainstem death and organ donation
- 18 Respiratory disorders
- 19 Rheumatological disorders
- 20 Disorders of the skeleton
- 21 Disorders of the kidney and urinary tract
- 22 Disorders of the blood
- 23 Disorders of the skin
- 24 Neurological disorders
- 25 The eye
- 26 Psychiatry and drug related problems
- 27 Forensic medicine
- 28 Sports medicine
- 29 Geratology
- 30 Pain
- 31 Palliative medicine
- 32 Biochemistry in medicine
- 33 Acute medicine