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Aug 3 & 8

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?


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