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Management of intracranial hypertension

  • Symposium on Neurological Disorder-Advances in Management-II
  • Published:
The Indian Journal of Pediatrics Aims and scope Submit manuscript

Abstract

Raised intracranial pressure (ICP) is a life threatening condition that is common to many neurological and non-neurological illnesses. Unless recognized and treated early it may cause secondary brain injury due to reduced cerebral perfusion pressure (CPP), and progress to brain herniation and death. Management of raised ICP includes care of airway, ventilation and oxygenation, adequate sedation and analgesia, neutral neck position, head end elevation by 20°–30°, and short-term hyperventilation (to achieve PCO2 32–35 mm Hg) and hyperosmolar therapy (mannitol or hypertonic saline) in critically raised ICP. Barbiturate coma, moderate hypothermia and surgical decompression may be helpful in refractory cases. Therapies aimed directly at keeping ICP <20 mmHg have resulted in improved survival and neurological outcome. Emerging evidence suggests that cerebral perfusion pressure targeted therapy may offer better outcome than ICP targeted therapies.

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Authors and Affiliations

  1. Pediatric Emergency and Intensive Care Units, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India

    Sunit C. Singhi & Lokesh Tiwari

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  1. Sunit C. Singhi
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  2. Lokesh Tiwari
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Correspondence to Sunit C. Singhi.

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Singhi, S.C., Tiwari, L. Management of intracranial hypertension. Indian J Pediatr 76, 519–529 (2009). https://doi.org/10.1007/s12098-009-0137-7

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  • DOI: https://doi.org/10.1007/s12098-009-0137-7

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