Increased ICP
Increased ICP
Increased ICP
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Prepared By
Ayesha Fareed
Introduction
Encephalopathy
Elevated ICP
Auto regulation
Auto regulation refers to the brain’s ability to change the diameter of its
blood vessels automatically to maintain a constant cerebral blood flow
during alterations in systemic blood pressure.
At a certain volume or pressure, the brain’s ability to auto regulate
becomes ineffective and decompensation(ischemia and infarction) begins.
When this occurs, the patient exhibits significant changes in mental status
and vital signs.
The bradycardia, hypertension, and bradypnea associated with this
deterioration are known as Cushing’s triad, a grave sign.
Clinical Manifestations
The earliest sign of increasing ICP is
change in Loss Of Control.
Slowing of speech and delay in response to verbal suggestions.
Restlessness (without apparent cause), confusion, or increasing
drowsiness
stuporous
Reacting only to loud auditory or painful stimuli.
comatose and exhibits abnormal motor responses in the form of
decortication, decerebration, or flaccidity
Detecting Later Signs of Increased ICP
LOC continues to deteriorate until the patient is comatose.
The pulse rate and respiratory rate decrease, and the blood pressure and
temperature rise.
Altered respiratory patterns develop, including Cheyne-Stokes breathing,
apnea, ataxic breathing.
Projectile vomiting
Hemiplegia or decorticate or decerebrate posturing
Loss of brain stem reflexes (pupillary, corneal, gag, and swallowing reflexes,
is an ominous sign)
Assessment and Diagnostic Findings
Cerebral angiography
Computed tomography (CT)
Scanning
Magnetic resonance imaging (MRI)
Positron emission tomography (PET)
Transcranial Doppler
Note: Lumbar puncture is avoided in patients with increased ICP
because then sudden release of pressure can cause the brain to herniate.
Complications
Coma
Coma is a clinical state of unconsciousness in which the
patient is unaware of self or the environment for prolonged
period.
Akinetic Mutism is a state of unresponsiveness to the
environment in which the patient makes no movement or
sound but sometimes opens the eyes.
Persistent vegetative state is a condition in which the
patient is described as wakeful but devoid of conscious
content, without cognitive or affective mental function.
Causes
CT Scan
MRI
PET
EEG
Laboratory Test
Serum Ammonia
Blood Urea
Nitrogen levels
Blood Glucose Level
Complications