Management of intracranial hypertension

• Published in: Neurologic clinics Vol. 26; no. 2; p. 521
• Main Authors: Rangel-Castilla, Leonardo, Rangel-Castillo, Leonardo, Gopinath, Shankar, Robertson, Claudia S
• Format: Journal Article
• Language: English
• Published: United States 01.05.2008
• Subjects: Acute Disease; Critical Care; Humans; Intracranial Hypertension - diagnosis; Intracranial Hypertension - physiopathology; Intracranial Hypertension - therapy; Monitoring, Physiologic
• ISSN: 0733-8619
• DOI: 10.1016/j.ncl.2008.02.003

Effective management of intracranial hypertension involves meticulous avoidance of factors that precipitate or aggravate increased intracranial pressure. When intracranial pressure becomes elevated, it is important to rule out new mass lesions that should be surgically evacuated. Medical management of increased intracranial pressure should include sedation, drainage of cerebrospinal fluid, and osmotherapy with either mannitol or hypertonic saline. For intracranial hypertension refractory to initial medical management, barbiturate coma, hypothermia, or decompressive craniectomy should be considered. Steroids are not indicated and may be harmful in the treatment of intracranial hypertension resulting from traumatic brain injury.