The Indian Journal of Pediatrics

, Volume 77, Issue 12, pp 1409–1416

Management of Raised Intracranial Pressure

  • Naveen Sankhyan
  • K. N. Vykunta Raju
  • Suvasini Sharma
  • Sheffali Gulati
Symposium on PICU protocols of AIIMS

DOI: 10.1007/s12098-010-0190-2

Cite this article as:
Sankhyan, N., Vykunta Raju, K.N., Sharma, S. et al. Indian J Pediatr (2010) 77: 1409. doi:10.1007/s12098-010-0190-2

Abstract

Appropriate management of raised intracranial pressure begins with stabilization of the patient and simultaneous assessment of the level of sensorium and the cause of raised intracranial pressure. Stabilization is initiated with securing the airway, ventilation and circulatory function. The identification of surgically remediable conditions is a priority. Emergent use of external ventricular drain or ventriculo-peritoneal shunt may be lifesaving in selected patients. In children with severe coma, signs of herniation or acutely elevated intracranial pressure, treatment should be started prior to imaging or invasive monitoring. Emergent use of hyperventilation and mannitol are life saving in such situations. Medical management involves careful use of head elevation, osmotic agents, and avoiding hypotonic fluids. Appropriate care also includes avoidance of aggravating factors. For refractory intracranial hypertension, barbiturate coma, hypothermia, or decompressive craniectomy should be considered.

Keywords

ComaCritically ill childIntracranial hypertensionTraumatic brain injury

Copyright information

© Dr. K C Chaudhuri Foundation 2010

Authors and Affiliations

  • Naveen Sankhyan
    • 1
  • K. N. Vykunta Raju
    • 1
  • Suvasini Sharma
    • 1
  • Sheffali Gulati
    • 1
  1. 1.Child Neurology Division, Department of PediatricsAll India Institute of Medical SciencesNew DelhiIndia