Monitoring and intraoperative management of elevated intracranial pressure and decompressive craniectomy.
Elevated intracranial pressure can be caused by a variety of underlying conditions. Several physiologic and pharmacologic factors have a significant impact on intracranial hypertension, mostly caused by changes on cerebral blood volume, flow, and oxygenation. There are many therapies that can be used to decrease intracranial pressure ranging from pharmacologic to the surgical decompressive removal of the calvarium. Special consideration is made for the anesthetic management of these patients perioperatively.
Department of Neurosurgery, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA. shihshan.lang@uphs.upenn.edu
Shih-Shan
SS
Lang
W Andrew
WA
Kofke
Michael F
MF
Stiefel
D000758:Anesthesia / Q000379:methods*; D001921:Brain / Q000601:surgery; D002560:Cerebrovascular Circulation / Q000187:drug effects / Q000502:physiology; D056424:Decompressive Craniectomy / Q000009:adverse effects / Q000379:methods*; D004232:Diuretics / Q000627:therapeutic use; D004322:Drainage; D006801:Humans; D006982:Hypertonic Solutions / Q000627:therapeutic use; D019586:Intracranial Hypertension / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D007427:Intracranial Pressure / Q000187:drug effects / Q000502:physiology; D007430:Intraoperative Care / Q000379:methods*; D008353:Mannitol / Q000627:therapeutic use; D016343:Monitoring, Intraoperative / Q000379:methods*; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods*; D010101:Oxygen Consumption / Q000187:drug effects / Q000502:physiology
D004232:Diuretics; D006982:Hypertonic Solutions; D008353:Mannitol