Correct Detailed Definitions (2026|2027)
Week 3: intracranial pressure, strokes, multiple sclerosis,
meningitis, encephalitis
Week 4: seizures week elimination (BPH, bladder infection,
dialysis)
Head Injury & Increased Intracranial Pressure (ICP)
ICP → Monro Kelly Doctrine – 3 components: brain,
cerebrospinal fluid, blood
Causes :
• Trauma
• Tumor Stroke
• Infection Early:
• headache,
• blurred vision (change in vision)
• change in LOC
,ICP late signs:
• Cushing’s triad
• → PP widening (systolic PP increases)
• RR irregular, bradycardia (low HR)
Opposite of a shock
→ S/S: ↓ BP, ↑ HR, ↑ RR
→ If someone comes to the hospital with these symptoms do a CT scan test
→ CT scan is quicker
→ For MRI the patient has to be stable
Reminder: with increase intracranial pressure NEVER do a lumbar puncture → reason: brain is
swelling already too much, the brain can come out of the skull
ICP treatment:
• position the patient 30° (not lying flat because it increases ICP),head neutral
• no increasing abdominal pressure (sneezing, coughing, straining with
BM)
, • only PRN suctioning (too much suctioning can increase the pressure) make sure
before suction pre hyperoxygenation the patient
ICP medication:
→ Mannitol (diuretic): watch for urine increasing (that’s the point), improvement in the sign and
symptoms (like ↑ LOC), headache went away → Dexamethasone ( Decadron) (steroid): watch
for ↑ blood sugar (even if you are not diabetic), watch for mood changes, they can retained
fluid
(edema)
Glasgow coma scale: max # 15, min # 3, 15 is a good number
• 3 mean they death no respond
• → less than 8 we intubate them (need airway open)
Make sure the 3 components are stable
• Eye Open
• Verbal Responds
• Motor response (no pupils here)
ICP posturing:
→ decorticate: arms like “T” moving towards spinal cord (flexion)
→ decerebrate: arms like “B” more extensive damage (extension)