A late indicator of increased intracranial pressure is:
A) Tachycardia
B) Right-sided heart failure
C) Narrow pulse pressure
D) High mean arterial pressure
Ans: D
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The cerebral perfusion pressure (CPP), which represents the difference between the mean arterial blood pressure (MABP) and the ICP (CPP = MABP – ICP), is the pressure perfusing the brain. CPP (normally 70 to 100 mm Hg) is determined by the pressure gradient between the internal carotid artery and the subarachnoid veins. The MABP and ICP are monitored frequently in persons with brain conditions that increase ICP and impair brain perfusion. When the pressure in the cranial cavity approaches or exceeds the MABP, tissue perfusion becomes inadequate, cellular hypoxia results, and neuronal death may occur. Elevated MABP, wide pulse pressure and reflex, and slowing of the heart rate are important but late indicators of increased ICP. Heart failure, not a part of the reflex, occurs with compression or herniation of the brain stem.
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