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Management of Raised Intracranial Pressure

  • Symposium on PICU protocols of AIIMS
  • Published:
The Indian Journal of Pediatrics Aims and scope Submit manuscript

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.

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Authors and Affiliations

  1. Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, 110029, India

    Naveen Sankhyan, K. N. Vykunta Raju, Suvasini Sharma & Sheffali Gulati

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  1. Naveen Sankhyan
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  2. K. N. Vykunta Raju
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  3. Suvasini Sharma
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  4. Sheffali Gulati
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Correspondence to Sheffali Gulati.

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Sankhyan, N., Vykunta Raju, K.N., Sharma, S. et al. Management of Raised Intracranial Pressure. Indian J Pediatr 77, 1409–1416 (2010). https://doi.org/10.1007/s12098-010-0190-2

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  • DOI: https://doi.org/10.1007/s12098-010-0190-2

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