Here's a brief and comprehensive summary on Increased Intracranial
Pressure (ICP), focusing on causes, symptoms, Cushing's triad, and treatment
— ideal for study or clinical reference
Increased Intracranial Pressure (ICP)
Normal ICP Range:
5–15 mmHg in adults
>20 mmHg is considered elevated and dangerous
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Causes of Increased ICP:
1. Traumatic Brain Injury (e.g., contusion, hematoma)
2. Brain Tumors
3. Hydrocephalus (excess CSF accumulation)
4. Cerebral Edema (due to trauma, stroke, infection)
5. Intracranial Hemorrhage (subdural, epidural, intracerebral)
6. CNS Infections (e.g., meningitis, encephalitis)
7. Stroke (ischemic or hemorrhagic)
8. Hypoxic brain injury
9. Abscess or mass lesions
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Symptoms of Increased ICP:
Headache (often worse in the morning)
Nausea and vomiting (projectile, without warning)
Altered level of consciousness (LOC) – drowsiness, confusion
Blurred vision or double vision
Papilledema (optic disc swelling)
Seizures
Behavioral changes
Decreased motor response
Pupillary changes – sluggish or unequal response
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Cushing’s Triad (Late sign of increased ICP):
A classic set of three signs indicating impending brain herniation:
1. Increased systolic blood pressure with widened pulse pressure
2. Bradycardia (slow heart rate)
3. Irregular respirations
> Cushing’s triad is a medical emergency.
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Treatment and Management of Increased ICP:
Medical Management:
Osmotic Diuretics (e.g., Mannitol): Decreases brain swelling
Hypertonic Saline: Reduces intracerebral fluid
Anticonvulsants: Prevent/treat seizures
Sedatives/Analgesics: Reduce metabolic demand
Corticosteroids: Useful in tumors (not recommended for trauma)
Barbiturate coma (in severe cases): Reduces cerebral metabolism
CSF drainage via ventriculostomy
Surgical Options:
Craniotomy or decompressive craniectomy
Removal of mass lesion or hematoma
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Nursing and Supportive Care:
Elevate HOB 30° and keep head midline
Monitor neurological status (GCS, pupils, vitals)
Maintain airway and oxygenation
Control fluid balance – avoid overload
Minimize environmental stimulation
Avoid activities that raise ICP (e.g., suctioning, straining)
Educate and support family
