Professional Documents
Culture Documents
10 mm Hg = Normal
> 20 mm Hg = Abnormal
> 40 mm Hg = Severe
Many Pathologic Processes affect outcome
Sustained ICP lead to brain function and
outcome
Autoregulation
By Mechanism
Blunt: High and
low velocity
Penetrating:
GSW and other
Classification of Brain Injury
Depressed / nondepressed
Vault
Open / Closed
By Morphology: Brain
Epidural (extradural)
Focal Subdural
Intracerebral
Concussion
Diffuse Multiple contusions
Hypoxic / ischemic injury
Diffuse Brain Injury
ABCDE
Minimize secondary brain injury
Administer O2
Maintain blood pressure
(systolic > 90 mm Hg)
Focused Neurologic Exam?
GCS score
Pupils
Lateralizing signs
Intravenous fluids
Euvolemia
Isotonic
Controlled ventilation
Goal: PaCO2 at 35 mm Hg
Indications for CT Scan?
Mannitol
Use with signs of tentorial herniation
Dose: 1.0 g / kg IV bolus
Consult with neurosurgeon first
Medical Management
Other medications
Anticonvulsants
Sedation
Paralytics
Surgical Management
Scalp Injuries
Possible site of major blood loss
Direct pressure to control bleeding
Occasional temporary closure
Surgical Management