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Management of intracranial hypertension

J I Frank1

  • 1Cleveland Clinic Foundation, Ohio.

The Medical Clinics of North America
|January 1, 1993
PubMed

Insights

Intracranial hypertension (ICH) management involves controlling aggravating factors and applying tailored therapies like hyperventilation or osmotic agents. Surgical intervention may be necessary for severe cases to reduce mortality.

Area of Science:

  • Neurology
  • Neurosurgery
  • Critical Care Medicine

Background:

  • Intracranial hypertension (ICH) is a critical factor in neurological patient outcomes.
  • Effective management of ICH is essential to prevent morbidity and mortality.
  • Diverse neurological conditions can lead to ICH.

Purpose of the Study:

  • To outline the therapeutic strategies for managing intracranial hypertension.
  • To emphasize the importance of individualized treatment approaches for ICH.
  • To discuss the role of conventional and surgical interventions in ICP reduction.

Main Methods:

  • Review of established treatment protocols for intracranial hypertension.
  • Analysis of factors that exacerbate elevated intracranial pressure (ICP).
  • Evaluation of conventional therapies including hyperventilation, osmotic agents, sedatives, barbiturates, and CSF removal.
  • Consideration of surgical options for refractory ICH.

Main Results:

  • Initial ICP reduction focuses on controlling aggravating factors (e.g., body position, temperature, pain, blood pressure, seizures).
  • Conventional therapies are selected based on individual patient clinical status and prognosis.
  • Surgical mass removal is indicated for intractable ICH and significant brain shifts.

Conclusions:

  • A heuristic, case-by-case application of therapeutic alternatives is crucial for managing ICH.
  • Prompt identification and control of ICP-aggravating factors are paramount.
  • Surgical intervention offers a vital option for severe, refractory intracranial hypertension.

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