Correct Measurement of Cerebral Perfusion Pressure (CPP)
For the monitoring of patients with intracranial mass lesions, the measurement of intracranial pressure (ICP) is an essential parameter. Therapy of brain swelling, indication for CT or even neurosurgical operations are often based on the us of the ICP. In addition, using arterial pressure (AP), the cerebral perfusion pressure (CPP) can be calculated (CPP = AP-ICP). CPP is important in considering extracranial factors, such as changes in blood volume or arterial pressure, resulting in secondary brain swelling and ischemia. In contrast to ICP monitoring, where hydrostatic level is easily standardized to the foramen of Monro, there exist various methods of measuring AP. It is usually not registered at the level of skull base, but in peripheral arteries with structural and functional differences (Gauer 1965). Previous investigations on CPP used varying mathematical methods for calculation of the mean arterial pressure, and the optimal grade of head elevation in intracranial hypertension is still under discussion.
KeywordsCatheter Ischemia Tempo
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