الفهرس 
Intracranial componentsOnly 14 pages are availabe for public view
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Abstract
Elevated intracranial pressure (ICP) is a potentially devastating
complication of neurologic injury. Elevated ICP may complicate trauma,
central nervous system (CNS) tumors, hydrocephalus, hepatic
encephalopathy, and impaired CNS venous outflow. Successful
management of patients with elevated ICP requires prompt recognition,
the judicious use of invasive monitoring, and therapy directed at both
reducing ICP and reversing its underlying cause.
The rapid recognition of elevated ICP is therefore of obvious and
paramount importance so that it can be monitored and so that therapies
directed at lowering ICP can be initiated. A raised ICP is measurable both
clinically and quantitatively. Continuous ICP monitoring is important
both for assessing the efficacy of therapeutic measures and for evaluating
the evolution of brain injury.
The goal of ICP monitoring is to ensure maintenance of optimal CPP.
The ICP also forms a basis for medical or surgical intervention in cases of
increased ICP with agents such as 3% sodium chloride (NaCl), mannitol,
or diuretics (Lasix), ventriculostomy, cerebrospinal fluid (CSF) diversion,
or surgical decompression in cases of intractable ICP elevation that do
not respond to conservative management.
There are four main anatomical sites used in the clinical measurement of
ICP: intraventricular, intraparenchymal, subarachnoid, and epidural
.Sometimes subdural and lumbar monitors are also used. Each technique
requires a unique monitoring system, and has associated advantages and
disadvantages.
ICP monitoring may be discontinued when the ICP remains in the
normal range within 48-72 hours of withdrawal of ICP therapy or if the
patient’s neurological condition improves to the point where he or she is
following commands.