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Monroe-Kellie Hypothesis intra-cranial volume cannot expand what contribute to ICP (intra cranial pressure)? brain (80%) + blood (10%) + CSF (10%) normal ICP 0-15 mmHg list treatments for excessive ICP - restrict fluid to 1/2 or 1/3 normalreqmts, monitor I/O closely - osmotic diuretics (mannitol) - hyperventilation: vasoconstriction from decr CO2 - CSF drain/tap (ventriculostomy): beware brain herniation via foramen magnum - surgical removal of obstruction (if present) - anti-seizure meds (seizure is common) when swelling occurs, what happens first? CSF is displaced (CSF is 10% of total head vol) is it OK to drain all CSF? yes, temporarily... CSF is not essential, we can live w/out it, and choroid plexus will regenerate more how fast is CSF made? 20cc/hr