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Increased Intracranial Pressure in Critically Ill Cancer Patients

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Abstract

Raised ICP can be seen with varied pathologies including traumatic brain injury (TBI), emergent large vessel occlusion stroke (ELVO), intracranial hemorrhage (ICH), primary versus metastatic neoplasms, diffuse brain processes such as cerebral edema, hepatic failure, inflammation and infection, hydrocephalus, and idiopathic.

ICP can be measured via an external ventricular drain (EVD) or a parenchymal bolt. Early clinical signs include headache, papilledema, nausea, stupor, and coma. Early recognition is helpful for early management to prevent cerebral hypoperfusion and brain death.

Management involves multiple tiers of therapies including head of bed up, sedation and analgesia, neuromuscular blockage, mild hyperventilation, and osmotherapy followed by barbiturate coma, therapeutic hypothermia, and aggressive hyperventilation. Last-ditch therapy involves decompressive hemicraniectomy. The use of multimodality monitoring helps in tailoring the appropriate therapy.

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Authors and Affiliations

  1. Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, USA

    Abhi Pandhi, Rashi Krishnan, Nitin Goyal & Marc Malkoff

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  1. Abhi Pandhi
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  2. Rashi Krishnan
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  3. Nitin Goyal
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  4. Marc Malkoff
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Correspondence to Abhi Pandhi .

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Editors and Affiliations

  1. Department of Critical Care, University of Texas MD Anderson Cancer C Department of Critical Care, Houston, TX, USA

    Joseph L. Nates

  2. Department of Critical Care, University of Texas MD Anderson Cancer C Department of Critical Care, Houston, TX, USA

    Kristen J. Price

Section Editor information

  1. Critical Care Department, Universidad del Rosario Hospital Universitario Fundacion Santa Fe de, Bogota, Colombia, Colombia

    Yenny Cardenas

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Pandhi, A., Krishnan, R., Goyal, N., Malkoff, M. (2019). Increased Intracranial Pressure in Critically Ill Cancer Patients. In: Nates, J., Price, K. (eds) Oncologic Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-319-74698-2_36-1

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