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Intracranial Pressure Reduction

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Management of Severe Traumatic Brain Injury

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Abstract

Elevated ICP should be anticipated in patients with traumatic brain injury. Peroperatively, ICP should be measured on wide indications and treatment should be instituted if ICP increases to more than 20 mmHg. The control of intracranial hypertension (ICP>20 mmHg) is based on the control of intracranial blood volume either via control of cerebral venous distension (central venous pressure, neck compression) or control by physiologic mechanisms including the chemical (PaCO2, PaO2, indomethacin, theophyllamine), neurogenic or hormonal (catecholamine), metabolic (hypnotics, analgesics, hypothermia), and autoregulatory control of cerebral circulation. Control of cerebral tissue water content is possible by osmotic-acting drugs like mannitol and hypertonic saline. During anaesthesia, it is important to have and apply a thorough understanding of the intracranial pathophysiology in order to avoid and treat intracranial hypertension in adults as well as in children.

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Authors and Affiliations

  1. Department of Neuroanaesthesia and Neurocritical care, Aarhus University Hospital, Noerrebrogade, 8000, Aarhus C, Denmark

    Bent Lob Dahl

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  1. Bent Lob Dahl
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Correspondence to Bent Lob Dahl .

Editor information

Editors and Affiliations

  1. , Department of Neurosurgery, Haukeland University Hospital, Jonas Liesvei 65, Bergen, 5021, Norway

    Terje Sundstrom

  2. , Department of Anaesthesia and Intensive, Lund University Hospital, Getingevägen 4, Lund, 22185, Sweden

    Per-Olof Grände

  3. Dept. Neuroanaesthesia & Neurosurgery, Arhus University Hospital, Aarhus C, 8000, Denmark

    Niels Juul

  4. , Department of Neurosurgery, Aarhus University Hospital, Norrebrograde 44, Aarhus C, 8000, Denmark

    Carsten Kock-Jensen

  5. , Department of Neurosurgery, Copenhagen University Hospital, Bledgamsvej 9, Copenhagen, 2100, Denmark

    Bertil Romner

  6. , Department of Surgical Sciences, University of Bergen, Jonas Liesvei, Bergen, 5021, Norway

    Knut Wester

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© 2012 Springer-Verlag Berlin Heidelberg

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Dahl, B.L. (2012). Intracranial Pressure Reduction. In: Sundstrom, T., Grände, PO., Juul, N., Kock-Jensen, C., Romner, B., Wester, K. (eds) Management of Severe Traumatic Brain Injury. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-28126-6_27

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  • DOI: https://doi.org/10.1007/978-3-642-28126-6_27

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-28125-9

  • Online ISBN: 978-3-642-28126-6

  • eBook Packages: MedicineMedicine (R0)

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