Emergency Neurological Life Support: Intracranial Hypertension and Herniation

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Robert D Stevens1, Michael Shoykhet2, Rhonda Cadena3

  • 1Departments of Anesthesiology and Critical Care Medicine, Neurology, Neurosurgery, and Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA. rstevens@jhmi.edu.

Neurocritical Care
|October 7, 2015
PubMed

Insights

Recognizing "brain codes" like intracranial hypertension and herniation is critical for immediate neurological emergency treatment. This protocol outlines a stepwise algorithm for managing these life-threatening brain events to prevent irreversible damage.

Area of Science:

  • Neurology
  • Emergency Medicine
  • Critical Care

Background:

  • Sustained intracranial hypertension and acute brain herniation represent critical neurological emergencies.
  • These conditions, termed "brain codes," necessitate urgent intervention to avert irreversible brain injury and mortality.

Purpose of the Study:

  • To establish an evidence-based, standardized protocol for the evaluation and management of intracranial hypertension and brain herniation.
  • To guide the organized, stepwise implementation of emergency neurological life support.

Main Methods:

  • Development of a management algorithm based on current evidence.
  • Standardization of diagnostic and therapeutic approaches for patients presenting with signs of increased intracranial pressure or herniation.

Main Results:

  • The protocol provides a structured approach to managing complex neurological emergencies.
  • Implementation aims to improve patient outcomes by ensuring timely and appropriate interventions.

Conclusions:

  • A standardized emergency neurological life support protocol is essential for managing "brain codes."
  • This evidence-based approach is crucial for optimizing the care of patients with intracranial hypertension and brain herniation.

Keywords:
Brain edemaHerniationHyperventilationOsmotherapy

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