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Updated: Feb 13, 2026

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Increased ICP and Its Cerebral Haemodynamic Sequelae.

Joseph Donnelly1, Marek Czosnyka2,3, Spencer Harland4

  • 1Brain Physics Laboratory, Division of Neurosurgery, Department of Clinical Neurosciences, Cambridge Biomedical Campus, University of Cambridge, Cambridge, CB2 0QQ, UK. jd634@cam.ac.uk.

Acta Neurochirurgica. Supplement
|March 2, 2018
PubMed
Summary

Increased intracranial pressure (ICP) harms brain blood flow, with cortical areas being particularly vulnerable. The brain uses rising blood pressure and altered vascular tension to protect itself from moderate to severe ICP elevations.

Keywords:
AutoregulationCerebral haemodynamicsCerebral perfusion pressureIntracranial pressure

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Area of Science:

  • Neurology
  • Cerebrovascular Physiology
  • Pathophysiology

Background:

  • Increased intracranial pressure (ICP) is a critical factor in various neurological conditions.
  • The precise local and systemic effects of elevated ICP on cerebral hemodynamics remain incompletely understood.
  • Understanding these consequences is vital for managing neurological diseases.

Purpose of the Study:

  • To investigate the cerebrovascular effects of acute increases in intracranial pressure (ICP).
  • To describe the relationship between ICP levels and cerebral blood flow dynamics.
  • To identify potential protective mechanisms against elevated ICP.

Main Methods:

  • Cerebral hemodynamics were assessed in rabbits using laser Doppler flowmetry (LDF) and Doppler ultrasonography.
  • Measurements included mean arterial blood pressure (MAP), ICP, basilar artery flow velocity (Fv), and estimated vascular wall tension (WT).
  • Intracranial hypertension was induced experimentally via artificial cerebrospinal fluid infusion.

Main Results:

  • Cortical LDF significantly decreased with increasing ICP, indicating reduced local blood flow.
  • Mean arterial blood pressure (MAP) increased progressively with rising ICP.
  • Vascular wall tension (WT) decreased at moderate ICP levels but remained unchanged at severe ICP levels, while flow velocity (Fv) decreased at severe ICP.

Conclusions:

  • The cerebral cortex exhibits vulnerability to increased ICP.
  • The brain employs distinct protective mechanisms: decreased WT and increased MAP buffer perfusion at moderate ICP.
  • At severe ICP, elevated MAP becomes the predominant cerebro-protective mechanism.