Chapter 47 Intracranial Pressure.docx

Chapter 47 Intracranial Pressure.docx - ANTIVIRAL FOR BELLS...

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ANTIVIRAL FOR BELLS PALSY ACYCLOVIR (SOVIUIRAX) IV OR PO ELCTROYMYOGRAPHY Chapter 47 Intracranial Pressure Intracranial Pressure Skull has three essential components: Brain tissue Blood Cerebrospinal fluid (CSF) Management base on the three of the following Factors that influence ICP Straining during defecation Coughing Sneezing Increased ICP leading cause of death from HA trauma who reach hospital alive Soft tissue in non-expandable container = more problems Arterial pressure Venous pressure Intraabdominal and intrathoracic pressure Influence your ICP Coughing contraindicated in BRAIN/EYE surgery Posture d/n lie flat Temperature Induce hyporthermia in surgery Blood gases (CO2 levels) vasodilation Regulation and Maintenance Monro-Kellie doctrine If one component increases, another must decrease to maintain ICP. Normal ICP 5 to 15 mm Hg Elevated if >20 mm Hg sustained Normal compensatory adaptations Changes in CSF volume
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Changes in intracranial blood volume Changes in tissue brain volume Ability to compensate is limited. If volume increase continues, ICP rises → decompensation Cerebral Blood Flow Definition The amount of blood in milliliters passing through 100 g of brain tissue in 1 minute About 50 mL/min per 100 g of brain tissue Cerebral Blood Flow Autoregulation Adjusts diameter of blood vessels Ensures consistent CBF Only effective if mean arterial pressure (MAP) 70 to 150 mm Hg for cerebral blood flow! Cerebral perfusion pressure (CPP) CPP = MAP – ICP Normal is 60 to 100 mm Hg. *DN have to calc just know what it is!! <50 mm Hg is associated with ischemia and neuronal death. Effect of cerebral vascular resistance CPP = Flow x Resistance Cerebral Blood Flow Pressure changes Compliance is the expandability of the brain. Impacts effect of volume change on pressure Compliance = Volume/Pressure Cerebral Blood Flow Stages of increased ICP Stage 1 :total compensation Stage 2 : ↓compensation; risk for ↑ICP Stage 3 : failing compensation; clinical manifestations of ↑ICP (Cushing’s triad) Stage 4 : Herniation imminent → death
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  • Spring '17
  • Acevedo
  • Intracranial pressure, Traumatic brain injury

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