Author(s): Ramesh Kumar R, Singhi SC, Singhi P
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Abstract Raised intracranial pressure is a life threatening condition; unless recognized and treated early, it may progress into herniation syndrome and death. Symptoms and signs are neither sufficiently sensitive nor specific, hence a high index of suspicion and vigilance are needed for early recognition. Immediate goal of management is to prevent / reverse herniation and to maintain good cerebral perfusion pressure. The therapeutic measures include stabilization of airway, breathing and circulation, along with neutral neck position, head end elevation by 30°, adequate sedation and analgesia, minimal stimulation, and hyperosmolar therapy (mannitol or 3\% saline). Short-term hyperventilation (to achieve PCO(2) ≈ 30 mm Hg) using bag ventilation can be resorted to if signs of impending herniation are present.
This article was published in Indian J Pediatr
and referenced in Journal of Trauma & Treatment