Management of Elevated Intracranial Pressure: a Review

Changa, Abhinav R; Czeisler, Barry; Lord, Aaron

doi:10.1007/s11910-019-1010-3

Cited by 38 publications

(30 citation statements)

References 50 publications

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“…Osmotherapy has been used as a foundation for managing elevated IcP levels induced by cerebral edema (5,6). commonly used osmotic agents include HS and mannitol (28,29). In the present study, to determine the effects of HS on IcP following ischemic stroke, the IcP of the rats were examined 0, 2, 4, 8, 12, 16, 20 and 24 h after McAO.…”

Section: Discussionmentioning

confidence: 96%

Elevated intracranial pressure induces IL‑1β and IL‑18 overproduction via activation of the NLRP3 inflammasome in microglia of ischemic adult rats

Ding

Wen

et al. 2020

Int J Mol Med

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Elevated intracranial pressure (IcP) is one of the most common complications following an ischemic stroke, and has implications for the clinical and neurological outcomes. The aim of the present study was to examine whether elevated IcP may increase IL-1β and IL-18 secretion by activating the NOD-like receptor protein 3 (NLRP3) inflammasome in microglia of ischemic adult rats. Sprague-dawley rats that underwent middle cerebral artery occlusion were used for assessment of IcP. Reactive oxygen species (ROS) production was detected, and western blotting and immunofluorescence staining were used to determine the expression levels of caspase-1, gasdermin d-N domains (GSdMd-N), IL-1β and IL-18 in microglial cells. ICP levels were significantly increased, which was accompanied by ROS overproduction, in the brain tissue following ischemia-reperfusion (IR) injury in rats. Treatment with 10% hypertonic saline by intravenous injection significantly reduced the ICP and ROS levels of the rats. Furthermore, high pressure (20 mmHg) combined with oxygen-glucose deprivation (OGd) treatment resulted in increased ROS production in BV-2 microglial cells compared with those subjected to OGd treatment alone in vitro. Elevated pressure upregulated the expression of caspase-1, GSdMd-N, IL-18 and IL-1β in IR-treated or OGd-treated microglia both in vivo and in vitro. More importantly, caspase-1, GSdMd-N, IL-18 and IL-1β expression in microglia was significantly downregulated when elevated pressure was reduced or removed. These results suggested that elevated IcP-induced IL-1β and IL-18 overproduction via activation of the NLRP3 inflammasome by ischemia-activated microglia may augment neuroinflammation.

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Section: Discussionmentioning

confidence: 96%

Elevated intracranial pressure induces IL‑1β and IL‑18 overproduction via activation of the NLRP3 inflammasome in microglia of ischemic adult rats

Ding

Wen

et al. 2020

Int J Mol Med

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“…Se ha evidenciado que en casos de hipertensión intracraneal de causa traumática, posterior al manejo del trauma, una de las medidas que benefician al paciente es la elevación de la cabecera a 30°, ya que de esta manera se reduce la PIC, al mismo tiempo que se mantiene la presión de perfusión cerebral. Además se ha establecido que para un mejor retorno venoso, se debe mantener la cabeza recta ya que esto evita la contorsión del sistema venoso yugular y en una paciente embarazada, se recomienda la posición decúbito lateral izquierdo (1,9).…”

Section: Manejo Inicial De La Hipertensión Intracraneal a Posición Del Pacienteunclassified

“…Los pacientes con lesión cerebral aguda se encuentran en riesgo potencial de presentar convulsiones tempranas, estas a su vez, aumentan de forma importante la PIC y la demanda metabólica (1,2,9).…”

Section: Terapia Antiepilépticaunclassified

“…Únicamente se ha mantenido de forma ocasional el uso de esteroides intravenosos en dosis altas y en combinación con acetazolamida para el manejo de la pérdida visual progresiva en la hipertensión intracraneal fulminante, esto de forma transitoria mientras se instaura el tratamiento definitivo. Son más recomendados en casos de efecto masa y tumores intracraneales ya que limitan el edema vasogénico intersticial y disminuyen el efecto masa hasta el tratamiento quirúrgico definitivo; aún así su uso es controversial (5,9,11).…”

Section: Corticoesteroidesunclassified

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Abordaje inicial de la hipertensión intracraneal en adultos

Egea

Acuña²,

Marín

2020

Rev.méd.sinerg.

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La presión intracraneal normal oscila entre 5-15mmHg. Cuando se eleva por encima de 20mmHg por más de 10 minutos, se define como hipertensión intracraneal. Trauma craneoencefálico, tumores y hemorragias cerebrales son posibles causas de hipertensión intracraneal. El paciente cursa con síntomas como bradicardia, hipertensión arterial y depresión respiratoria. Las principales medidas de abordaje incluye elevar la cabecera, sedación, control de presión arterial, mantener la presión de perfusión cerebral >60mmHg y el uso de manitol y/o solución salina hipertónica. La hiperventilación es una medida terapéutica. La profilaxis antiepiléptica es controversial. La hipotermia ha demostrado neuroprotección. Las posibles complicaciones si se retrasa el manejo incluyen edema cerebral grave y daños neurológicos irreversibles.

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“…[1][2][3] In addition, early and accurate diagnosis is of great importance in preventing possible complications and determining treatment strategies in these patients. [4][5][6] ICP can be measured with tools that can be placed intraparenchymal and intraventricular. Although ICP can be measured directly with these tools, there are dangerous complications of it such as bleeding and infection.…”

Section: Introductionmentioning

confidence: 99%

Türkiye'de Sağlıklı Erişkinlerde Optik Sinir Kılıfı Çapının Değerlendirilmesi

Gökçen¹,

Çalteki̇n²,

Albayrak³

et al. 2021

Sakarya Medical Journal

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Objective The ultrasonographically detected optic nerve sheath diameter (ONSD) measurement is a practical and non-invasive method for the detection of increased intracranial pressure. However, it is important to know the normal ONSD values of a healthy population in the interpretation of pathological ONSD values. In this study, we aimed to investigate how the normal values of ONSD are distributed in normal healthy volunteers in Turkish population. Materials and MethodsThis descriptive cross sectional type design study was planned between November 15, 2019 and April 15, 2020. The study included 160 healthy volunteers who were over 18 years of age and didn't have acute and chronic systemic disorders. ONSD of the subjects were measured from both eyes ultrasonographically.Results ONSD means (median, IQR) of right and left eyes of the subjects were measured as 4.87 (0.41) mm and 4.86 (0.32) mm, respectively. Right and left eye ONSD measurements were detected lower in female gender than men, and this difference was statistically significant. (p = 0.017 and p = 0.031, respectively).Conclusion It was found ONSD value as 4.87 (0.41) for the right eye and 4.86 (0.32) mm for the left eye in healthy individuals in Turkish population in our study. Determination of ONSD optimal reference values in healthy individuals would benefit in predicting increase in intracranial pressure in clinical practice. Keywords optic nerve sheath diameter; ultrasonography; healthy volunteer Öz Amaç Artmış intrakranial basınç artışının tespitinde ultrasonografik olarak tespit edilen optik sinir kılıf çapı (OSKÇ) ölçümü pratik ve non invaziv bir yöntemdir. Bununla birlikte patolojik OSKÇ değerlerinin yorumlanmasında sağlıklı bir popülasyonun normal OSKÇ değerlerinin bilinmesi önem arz eder. Biz bu çalışmada Türk popülasyonundaki normal sağlıklı gönüllülerde OSKÇ normal değerlerinin nasıl dağıldığını araştırmak istedik.

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Management of Elevated Intracranial Pressure: a Review

Cited by 38 publications

References 50 publications

Elevated intracranial pressure induces IL‑1β and IL‑18 overproduction via activation of the NLRP3 inflammasome in microglia of ischemic adult rats

Elevated intracranial pressure induces IL‑1β and IL‑18 overproduction via activation of the NLRP3 inflammasome in microglia of ischemic adult rats

Abordaje inicial de la hipertensión intracraneal en adultos

Türkiye'de Sağlıklı Erişkinlerde Optik Sinir Kılıfı Çapının Değerlendirilmesi

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