Intracranial Pressure Reduction

  • Bent Lob Dahl


Elevated ICP should be anticipated in patients with traumatic brain injury. Peroperatively, ICP should be measured on wide indications and treatment should be instituted if ICP increases to more than 20 mmHg. The control of intracranial hypertension (ICP>20 mmHg) is based on the control of intracranial blood volume either via control of cerebral venous distension (central venous pressure, neck compression) or control by physiologic mechanisms including the chemical (PaCO2, PaO2, indomethacin, theophyllamine), neurogenic or hormonal (catecholamine), metabolic (hypnotics, analgesics, hypothermia), and autoregulatory control of cerebral circulation. Control of cerebral tissue water content is possible by osmotic-acting drugs like mannitol and hypertonic saline. During anaesthesia, it is important to have and apply a thorough understanding of the intracranial pathophysiology in order to avoid and treat intracranial hypertension in adults as well as in children.


Traumatic Brain Injury Cerebral Blood Flow Intracranial Hypertension Cerebral Perfusion Pressure Hypertonic Saline 
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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Department of Neuroanaesthesia and Neurocritical careAarhus University HospitalAarhus CDenmark

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