Intracranial hypertension is arbitrarily defined as an intracranial pressure greater than 20–22 mmHg. The understanding of the mechanisms responsible for maintenance of intracranial pressure (ICP) in the normal range and how their disruption results in intracranial hypertension and its consequences, e.g., the herniation syndromes, is essential to adequate therapeutic management. The knowledge of early ICP-reduction directed interventions aiming to avoid secondary brain injury are crucial for improved outcomes in situations like a traumatic brain injury. In this setting, the individualized patient’s monitorization through advanced brain monitoring, e.g., real-time parenchymal pressure, and the implementation of the current therapies toward elevated ICP including patient positioning, adequate perfusion pressure, sedation, osmotherapy, and surgical decompression are necessary tools for the neurocritical care intensivist.
KeywordsIntracranial pressure Intracranial hypertension Cerebral herniation Cerebrovascular circulation
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