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Decompressive laparotomy: a novel approach in the management of severe intracranial hypertension

Maurizio A Miglietta1, Laura J Salzano, William C Chiu

  • 1Trauma and Surgical Critical Care, R Adams Cowley Shock Trauma Center, University of Maryland, Baltimore, 21201-1595, USA. drmiglietta@aol.com

The Journal of Trauma
|September 23, 2003
PubMed
Abstract

No abstract available in PubMed .

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Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...