Book contents
- Frontmatter
- Dedication
- Contents
- List of contributors
- Editor's preface
- PART I INTRODUCTION AND GENERAL PRINCIPLES
- PART II DISORDERS OF HIGHER FUNCTION
- PART III DISORDERS OF MOTOR CONTROL
- PART IV DISORDERS OF THE SPECIAL SENSES
- PART V DISORDERS OF SPINE AND SPINAL CORD
- PART VI DISORDERS OF BODY FUNCTION
- PART VII HEADACHE AND PAIN
- PART VIII NEUROMUSCULAR DISORDERS
- PART IX EPILEPSY
- PART X CEREBROVASCULAR DISORDERS
- PART XI NEOPLASTIC DISORDERS
- PART XII AUTOIMMUNE DISORDERS
- PART XIII DISORDERS OF MYELIN
- PART XIV INFECTIONS
- PART XV TRAUMA AND TOXIC DISORDERS
- PART XVI DEGENERATIVE DISORDERS
- PART XVII NEUROLOGICAL MANIFESTATIONS OF SYSTEMIC CONDITIONS
- 121 Neurological aspects of pregnancy
- 122 The brain and the cardiovascular system
- 123 Neurological complications of hepatic and gastrointestinal disease
- 124 Renal disease and electrolyte disturbances
- 125 Disorders of intracranial pressure
- 126 Neurologic manifestations of endocrine disease
- 127 Neurological manifestations of hematological diseases
- 128 Neurocutaneous syndromes
- 129 Neurological complications after organ transplantation
- Complete two-volume index
- Plate Section
125 - Disorders of intracranial pressure
from PART XVII - NEUROLOGICAL MANIFESTATIONS OF SYSTEMIC CONDITIONS
Published online by Cambridge University Press: 05 August 2016
- Frontmatter
- Dedication
- Contents
- List of contributors
- Editor's preface
- PART I INTRODUCTION AND GENERAL PRINCIPLES
- PART II DISORDERS OF HIGHER FUNCTION
- PART III DISORDERS OF MOTOR CONTROL
- PART IV DISORDERS OF THE SPECIAL SENSES
- PART V DISORDERS OF SPINE AND SPINAL CORD
- PART VI DISORDERS OF BODY FUNCTION
- PART VII HEADACHE AND PAIN
- PART VIII NEUROMUSCULAR DISORDERS
- PART IX EPILEPSY
- PART X CEREBROVASCULAR DISORDERS
- PART XI NEOPLASTIC DISORDERS
- PART XII AUTOIMMUNE DISORDERS
- PART XIII DISORDERS OF MYELIN
- PART XIV INFECTIONS
- PART XV TRAUMA AND TOXIC DISORDERS
- PART XVI DEGENERATIVE DISORDERS
- PART XVII NEUROLOGICAL MANIFESTATIONS OF SYSTEMIC CONDITIONS
- 121 Neurological aspects of pregnancy
- 122 The brain and the cardiovascular system
- 123 Neurological complications of hepatic and gastrointestinal disease
- 124 Renal disease and electrolyte disturbances
- 125 Disorders of intracranial pressure
- 126 Neurologic manifestations of endocrine disease
- 127 Neurological manifestations of hematological diseases
- 128 Neurocutaneous syndromes
- 129 Neurological complications after organ transplantation
- Complete two-volume index
- Plate Section
Summary
Intracranial pressure (ICP) is the pressure within the cranial vault relative to the atmospheric pressure. Quincke first measured cerebrospinal fluid (CSF) pressure in 1891 via a lumbar puncture (Quincke, 1891). In 1902, Cushing demonstrated hypertension, bradycardia and respiratory changes in an animal model with severe ICP elevation (Cushing, 1902). In 1951, Guillaume and Janny first described the use of continuous ICP monitoring using an intraventricular catheter (Guillaume & Janny, 1951). Nine years later, Lundberg described ICP wave patterns and their response to medical and physiological interventions (Lundberg, 1960).
ICP measurement has been an invaluable tool in research and clinical practice. It has contributed much to the understanding of intracranial pathologies, and assessment of therapeutic interventions. Intracranial hypertension is the elevation of the intracranial pressure to levels that may lead to neurological injury. ICP monitoring is used for patients with neurological disorders that have a high risk of further neurological injury from increased ICP or mass effect. In this chapter, we discuss the physiology related to ICP, the techniques in measuring ICP, interpretation of ICP recordings, common ICP disorders and their management (including intracranial hypotension), and outcome studies of ICP monitoring and management of intracranial hypertension.
Intracranial physiology and intracranial Pressure
The pressure wave of the ICP is generated by the transmission of arterial pressure from the major cerebral arteries (Martins et al., 1972) and CSF production by choroid plexus (Cardoso et al., 1983) in the cranial vault. In normal conditions, the transmitted pressure is attenuated by displacement of CSF back and forth through the foramen magnum into the distensible spinal dural sac. This provides a compliance mechanism for the cranial vault (Martins et al., 1972). In adults, the range of normal resting ICP is 0 to 15mm Hg (0 to 20cm H2O). Sustained ICP greater than 15mm Hg is considered abnormal. The relation of ICP to brain injury depends on the cause, acuity, severity and duration of the ICP. Transient elevations of ICP occur with coughing, sneezing, or Valsalva manoeuvres and do not cause harm in most persons.
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- Diseases of the Nervous SystemClinical Neuroscience and Therapeutic Principles, pp. 2016 - 2032Publisher: Cambridge University PressPrint publication year: 2002