Neurointensivism in patients with increased intracranial pressure
Inrtoduction. Intracranial hypertension is associated with a high mortality in patients with various encephalo-cranial disorders, so that it is important to recognize and treat the condition without delay. Development. The main factors interacting to maintain normal intracranial pressure are the cerebral blood flow, arteriolar radius, cerebral perfusion pressure and plasma viscosity. Current treatment of raised intracranial pressure is aimed to restore these factors to normal, so as to maintain equilibrium between encephalic mass, cerebro-spinal fluid and blood volume. As well as traditional measures such as hyperventilation, administration of mannitol and barbiturates, today there are also new treatments available to the intensive care neurologist: hypertonic saline solutions, hypothermia, craniectomies and neuroprotective agents.
Desarrollo Los principales factores que interactúan para mantener la presión intracraneal normal son el flujo sanguíneo cerebral, el radio arteriolar, la presión de perfusión cerebral y la viscosidad plasmática. El tratamiento actual del aumento de la presión intracraneal va encaminado a normalizar estos factores, para mantener el equilibrio entre la masa encefálica, el líquido cefalorraquídeo y el volumen sanguíneo. Además de las medidas tradicionales tales como hiperventilación, administración de manitol y barbitúricos, hoy en día contamos con nuevas terapias que han ampliado el armamentario del neurointensivista: soluciones salinas hipertónicas, hipotermia, craniectomías y agentes neuroprotectores
