Chapter

Raised intracranial pressure, cerebral oedema, and hydrocephalus

Ian Whittle

in Brain's Diseases of the Nervous System

Edition 12

Published on behalf of Oxford University Press

ISBN: 9780198569381
Published online July 2011 | e-ISBN: 9780199640232 | DOI: http://dx.doi.org/10.1093/med/9780198569381.003.0604
Raised intracranial pressure, cerebral oedema, and hydrocephalus

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The brain is protected by the cranial skeleton. Within the intracranial compartment are also cerebrospinal fluid, CSF, and the blood contained within the brain vessels. These intracranial components are in dynamic equilibrium due to the pulsations of the heart and the respiratory regulated return of venous blood from the brain. Normally the mean arterial blood pressure, systemic venous pressure, and brain volume are regulated to maintain physiological values for intracranial pressure, ICP. There are a range of very common disorders such as stroke, and much less common, such as idiopathic intracranial hypertension, that are associated with major disturbances of intracranial pressure dynamics. In some of these the contribution to pathophysiology is relatively minor whereas in others it may be substantial and be a major contributory factor to morbidity or even death.

Intracranial pressure can be disordered because of brain oedema, disturbances in CSF flow, mass lesions, and vascular engorgement of the brain. Each of these may have variable causes and there may be interactions between mechanisms. In this chapter the normal regulation of intracranial pressure is outlined and some common disease states in clinical neurological practice that are characterized by either primary or secondary problems in intracranial pressure dynamics described.

Chapter.  12677 words.  Illustrated.

Subjects: Neurology

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