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Chapter 16 - Increased Intracranial Pressure and Herniation Syndromes

from Section 3 - Specific Neurological Disorders in Emergency Medicine

Published online by Cambridge University Press:  10 January 2024

By
Diana J. Jho ,
Brian Rempe ,
James Burgess  and
Alexander K. Yu
Edited by
Thomas P. Campbell  and
Kevin M. Kelly
Thomas P. Campbell
Affiliation:
Allegheny Health Network, Pittsburgh
Kevin M. Kelly
Affiliation:
Allegheny Health Network, Pittsburgh
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Summary

The cranial vault in an adult is an enclosed space encased by the rigid skull. The Monro–Kellie doctrine proposed in the early nineteenth century states that the volume inside the cranium is fixed and normally filled with the brain, cerebral spinal fluid, and blood in a state of equilibrium. An increase in the volume of one of these constituents must be compensated by a decrease in another. Intracranial pressure (ICP) is the pressure inside the skull due to the volume within the cranium. Elevated ICP can be severely debilitating and even life-threatening. It is very important to quickly identify signs and symptoms of elevated ICP, diagnose the pathology, and promptly initiate treatment in the emergency setting to prevent irreparable brain damage, significant disability, or death.

Keywords

Cushing’s reflexcerebral autoregulationvasogenic edemacytotoxic edemainterstitial edemaosmotic edemasubfalcine herniationuncal herniationtranstentorial herniationcerebellar tonsillar herniation
Type
Chapter
Information
Handbook of Emergency Neurology , pp. 235 - 245
Publisher: Cambridge University Press
Print publication year: 2023

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