Abstract
A 2-year-old unconscious child was brought to the emergency department following fall from the first floor of a building. Initial Glasgow coma score was 6. Both pupils were reactive, blood pressure was 95 mmHg systolic, and heart rate was 120/min. Head CT on admission revealed multiple contusions with cerebral edema. Within 30 min of admission, blood pressure shot up to 130 mmHg, heart rate dropped to 70/min, and the right pupil got dilated.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
Suggested Reading
Agbeko RS, Pearson S, Peters MJ, et al. Intracranial pressure and cerebral perfusion pressure responses to head elevation changes in pediatric traumatic brain injury. Pediatr Crit Care Med. 2012;e39:13.
Hutchinson PJ, Kolias AG, Timofeev IS, et al. Trial of decompressive craniectomy for traumatic intracranial hypertension. N Engl J Med. 2016;375:1119.
Kochanek PM, Carney N, Adelson PD, et al. Guidelines for the acute medical management of severe traumatic brain injury in infants, children, and adolescents—second edition. Pediatr Crit Care Med. 2012;13(Suppl 1):S1. Evidence based guidelines for managing traumatic brain injury in infants.
Kumar R, Singhi S, Singhi P, Jayashree M, Bansal A, Bhatti A. Randomized controlled trial comparing cerebral perfusion pressure-targeted therapy versus intracranial pressure-targeted therapy for raised intracranial pressure due to acute CNS infections in children. Crit Care Med. 2014;42(8):1775–87.
Meyer MJ, Megyesi J, Meythaler J, Murie-Fernandez M, Aubut JA, Foley N, Salter K, Bayley M, Marshall S, Teasell R. Acute management of acquired brain injury part I: an evidence-based review of non-pharmacological interventions. Brain Inj. 2010;24(5):694–705. There is a paucity of information regarding nonpharmacological acute management of patients with ABI. This review found strong levels of evidence for only four interventions (decompressive craniectomy, cerebrospinal fluid drainage, hypothermia, and hyperbaric oxygen).
Singhi SC, Tiwari L. Management of intracranial hypertension. Indian J Pediatr. 2009;76(5):519–29. A review article on the management of acute intracranial hypertension.
Stevens RD, Shoykhet M, Cadena R. Emergency neurological life support: intracranial hypertension and herniation. Neurocrit Care. 2015;23(Suppl 2):S76.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Singapore Pte Ltd.
About this chapter
Cite this chapter
Singhi, S. (2020). Acute Intracranial Hypertension. In: Chawla, R., Todi, S. (eds) ICU Protocols. Springer, Singapore. https://doi.org/10.1007/978-981-15-0902-5_37
Download citation
DOI: https://doi.org/10.1007/978-981-15-0902-5_37
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-15-0901-8
Online ISBN: 978-981-15-0902-5
eBook Packages: MedicineMedicine (R0)