Management of intracranial hypertension in patients neurocriticos: integrative review

Untitled

“…There is also a reduction in CSF absorption involved in the reduction of cerebral blood flow. 33 The HIC vascular occurs in various situations such as: 33 Cerebral vascular -Doenças: cerebral venous thrombosis and thrombosis upper sagittal sinus thrombosis mastoiditis with the transverse sinus or sigmoid (the "optical hydrocephalus" described by Simonds); Extra-cerebral -Doenças: as acute hypertension hypertensive encephalopathy, encephalopathy in cases of malignant hypertension of whatever cause, glomerulonephritis, eclampsia, etc., or reduced cerebral venous flow in congestive heart failure, superior vena cava syndrome or mass lesions intrathoracic. The third (HIC caused by disturbances of the dynamics of cerebrospinal fluid) It is related to the dynamics of cerebrospinal fluid, which includes all aspects of the CSF circulation (from production to absorption).…”

“…Their clinical characteristics are similar to a hydrocephalus obstrutiva. 33 And last is the HIC idiopathic where its pathogenesis is not yet established and understood in its entirety. 34,35 This is characterized as the persistent increase in PIC in the absence of intracranial lesions: intracranial tumor, hydrocephalus, intracranial infection, dural sinus thrombosis or hypertensive encephalopathy.…”

“…The diagnosis of this type of HIC is done only after measuringPIC and the full exploitation of neuroimaging. [33][34][35] Bearing on the admission of a patient with neurological disorders, monitoring of PIC is indicated at times: 6 i. In cases of patients presenting Glasgow Coma Scale of 3 to 8 (after resuscitation), abnormal presentation of head CT, hematoma and/ or brain edema, cranial contusion, herniation, compressed basal cisterns.…”

“…The CSF changes that lead to HIC, generally, are those that cause obstruction of cerebrospinal fluid flow at any point in its path and causing difficulty in resorption LCR. 33 The total volume of the intracranial blood is approximately 4 to 4.5 ml / 100 g of brain tissue, which normally is distributed by 60% in the venous side and 40% on the arterial side. Clinically, the venous system can be regarded as incompressible and the vessels of the venous system are unchanged from their diameters, so the entire stroke response is the blood side, which is less than 2% of the intracranial volume or about 25 ml in the adult brain.…”

“…Clinically, the venous system can be regarded as incompressible and the vessels of the venous system are unchanged from their diameters, so the entire stroke response is the blood side, which is less than 2% of the intracranial volume or about 25 ml in the adult brain. 33 Cerebral blood flow (CBF) is directly proportional to cerebral perfusion pressure (CPP) and inversely proportional to the cerebral vascular resistance (SVR). PCP is proportional to the mean arterial pressure (MAP) under venous pressure.…”