Increased Intracranial Pressure in Critically Ill Cancer Patients

  • Abhi PandhiEmail author
  • Rashi Krishnan
  • Nitin Goyal
  • Marc Malkoff
Reference work entry


Raised ICP can be seen with varied pathologies including traumatic brain injury (TBI), emergent large vessel occlusion stroke (ELVO), intracranial hemorrhage (ICH), primary versus metastatic neoplasms, diffuse brain processes such as cerebral edema, hepatic failure, inflammation and infection, hydrocephalus, and idiopathic.

ICP can be measured via an external ventricular drain (EVD) or a parenchymal bolt. Early clinical signs include headache, papilledema, nausea, stupor, and coma. Early recognition is helpful for early management to prevent cerebral hypoperfusion and brain death.

Management involves multiple tiers of therapies including head of bed up, sedation and analgesia, neuromuscular blockage, mild hyperventilation, and osmotherapy followed by barbiturate coma, therapeutic hypothermia, and aggressive hyperventilation. Last-ditch therapy involves decompressive hemicraniectomy. The use of multimodality monitoring helps in tailoring the appropriate therapy.


Intracranial pressure Cerebral herniation Osmotherapy Craniectomy Indices indicated in green color 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Abhi Pandhi
    • 1
    Email author
  • Rashi Krishnan
    • 1
  • Nitin Goyal
    • 1
  • Marc Malkoff
    • 1
  1. 1.Department of NeurologyUniversity of Tennessee Health Science CenterMemphisUSA

Section editors and affiliations

  • Yenny Cardenas
    • 1
  1. 1.Critical Care DepartmentUniversidad del Rosario Hospital Universitario Fundacion Santa Fe deBogotaColombia

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