Neurol. praxi. 2009;10(1):13-18

Pathophysiology and therapeutic options of intracranial hypertension

MUDr. Miroslav Kalina

Neurologické oddělení Nemocnice Na Homolce, Praha

Intracranial hypertension has a number of causes with converging mechanisms of secondary brain damage. Vascular autoregulation,

blood-brain barrier disruption, membrane depolarization, biochemical cascade with glutamate and free radicals´ effects, and mechanisms

of interstitial and intracellular edema are analysed. Common and specific therapeutic measures based on these pathophysiological

processes are derived: complex monitoring including intracranial pressure, cerebral perfusion pressure control, sedation, analgesia,

therapeutic hyperventilation, barbiturate coma, external ventricular drainage, decompressive craniectomy with focus on new indications

in malignant ischemic stroke in the middle cerebral artery territory.

Keywords: intracranial hypertension, secondary cerebral damage, cerebral oedema, vascular autoregulation, cerebral perfusion pressure, external ventricular drainage, decompressive craniectomy, malignant infarction.

Published: March 1, 2009  Show citation