Intracranial pressure in nontraumatic ischemic and hypoxic cerebral insults

Abstract

Intracranial pressure (ICP) and cerebral perfusion pressure were monitored in 12 patients who were comatose secondary to hypoxic (5 cases) or hypotensive (7 cases) nontraumatic cerebral insults. Patients who were hypotensive but not hypoxic developed significant increased ICP. In patients who were comatose from hypoxic cerebral insults without hypotension, ICP was normal. When an increase in ICP was diagnosed, patients were managed aggressively to improve cerebral perfusion and lower ICP. Although a functional salvage rate of 25% was obtained, this may reflect the severity of the initial cerebral insult rather than the effect of treatment. To prevent the potential deleterious effects of raised ICP, monitoring ICP and maintaining adequate perfusion may be warranted in comatose patients who have suffered nontraumatic diffuse ischemic but not purely hypoxic cerebral insults.