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Emergency management of increased intracranial pressure

Alexander Fraser Pitfield1, Allison B Carroll, Niranjan Kissoon

  • 1Division of Critical Care, Department of Pediatrics, British Columbia Children's Hospital, The University of British Columbia, Vancouver, British Columbia, Canada.

Pediatric Emergency Care
|February 7, 2012
PubMed

Insights

Early identification and treatment of increased intracranial pressure (ICP) are crucial in children with neurological injuries to prevent secondary brain damage. Prompt management optimizes outcomes by reducing ICP and ensuring adequate cerebral perfusion.

Area of Science:

  • Pediatric Neurology
  • Neurocritical Care
  • Emergency Medicine

Background:

  • Children face neurological injury from trauma, tumors, and infections.
  • Secondary brain injury can result from elevated intracranial pressure (ICP) due to primary insult or treatment delays.

Purpose of the Study:

  • To identify pediatric patients at risk for intracranial hypertension.
  • To provide a framework for emergency department (ED) investigation and management of increased ICP.
  • To outline intensive care unit (ICU) management for refractory ICP.

Main Methods:

  • Review of contemporary guidelines for managing increased ICP in pediatric neurological injury.
  • Framework for early identification and risk stratification in the ED.
  • Discussion of targeted therapies and ICU management strategies.

Main Results:

  • Early diagnosis and aggressive treatment of increased ICP are vital for preventing secondary brain injury.
  • Management focuses on reducing ICP while optimizing cerebral perfusion and metabolic demands.
  • Emergency physicians play a critical role in initial identification and treatment.

Conclusions:

  • Prompt intervention for increased ICP in pediatric neurological injury is essential for improving survival and neurological outcomes.
  • A systematic approach in the ED and subsequent ICU care is necessary for effective management.
  • Targeted therapies should be implemented early to mitigate preventable brain injury.

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