Raised Intra cranial Pressure will cause: March 2007
Ans. C: Papilloedema ICP at rest is normally 7-15 mmHg for a supine adult, and becomes negative (averaging "10 mmHg) in the veical position. Increased ICP One of the most damaging aspects of brain trauma and other conditions, directly correlated with poor outcome, is an elevated intracranial pressure. The body's response to a decrease in CPP is to raise blood pressure and dilate blood vessels in the brain. This results in increased cerebral blood volume, which increases ICP, lowering CPP fuher and causing a vicious cycle. Neurologic changes seen in increased ICP are mostly due to hypoxia and hypercapnea and are as follows: decreased LOC, Cheyne-Stokes respirations, hyperventilation, sluggish dilated pupils and widened pulse pressure. Signs and symptoms of increased ICP In general, symptoms and signs that suggest a rise in ICP including headache, nausea, vomiting, ocular palsies, altered level of consciousness, and papilledema. If papilledema is protracted, it may lead to visual disturbances, optic atrophy, and eventually blindness. In addition to the above, if mass effect is present with resulting displacement of brain tissue, additional signs may include pupillary dilatation, abducens (CrN VI) palsies, and the Cushing's triad. Cushing's triad involves an increased systolic blood pressure, a widened pulse pressure, bradycardia, and an abnormal respiratory pattern. In children, a slow hea rate is especially suggestive of high ICP. Irregular respirations occur when injury to pas of the brain interfere with the respiratory drive. In infants and small children, the effects of ICP differ because their cranial sutures have not closed. In infants, the fontanelles, or soft spots on the head where the skull bones have not yet fused, bulge when ICP gets too high.
Tachycardia
Hypotension
Papilloedema
Normal looking anterior fontanelle in infants