Ramon is a 26-year-old male who presented with a severe headache and syncope episode. He was found to have a mass in his head, which was surgically removed
Now 12 hours later, he has increased intracranial pressure (as measured by a machine, showing increased ICP).
a. Explain what intracranial pressure is and what can cause increased intracranial pressure.
b. How is ICP normally compensated?
Students' answers should include the following:
a. Blood, CSF, and brain make up the space inside the cranium.
If one or more increases without decrease in the other two, ICP becomes elevated.
Normal ICP is 15 or below; normal cerebral perfusion pressure (CPP) is 70 to 100 mm Hg.
Brain tumors, swelling, bleeding, inflammatory disorders, meningitis, or encephalitis cause increase.
Only exit for brain from swelling is the foramen magnum, lower part of skull where upper spine connects
Brain stem will herniate.
Cushing's triad
Cheyne-Stokes respirations
Decorticate/decerebrate posturing
Death may result if unresolved.
b. ICP increases when initial compensation occurs, CPP production decreases, if ICP continues to elevate, and vascular autoregulatory mechanisms fail.
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