Monitoring and intraoperative management of elevated intracranial pressure and decompressive craniectomy

Anesthesiol Clin. 2012 Jun;30(2):289-310. doi: 10.1016/j.anclin.2012.05.008.

Abstract

Elevated intracranial pressure can be caused by a variety of underlying conditions. Several physiologic and pharmacologic factors have a significant impact on intracranial hypertension, mostly caused by changes on cerebral blood volume, flow, and oxygenation. There are many therapies that can be used to decrease intracranial pressure ranging from pharmacologic to the surgical decompressive removal of the calvarium. Special consideration is made for the anesthetic management of these patients perioperatively.

Publication types

  • Review

MeSH terms

  • Anesthesia / methods*
  • Brain / surgery
  • Cerebrovascular Circulation / drug effects
  • Cerebrovascular Circulation / physiology
  • Decompressive Craniectomy / adverse effects
  • Decompressive Craniectomy / methods*
  • Diuretics / therapeutic use
  • Drainage
  • Humans
  • Hypertonic Solutions / therapeutic use
  • Intracranial Hypertension / diagnosis*
  • Intracranial Hypertension / physiopathology
  • Intracranial Hypertension / therapy*
  • Intracranial Pressure / drug effects
  • Intracranial Pressure / physiology
  • Intraoperative Care / methods*
  • Mannitol / therapeutic use
  • Monitoring, Intraoperative / methods*
  • Neurosurgical Procedures / adverse effects
  • Neurosurgical Procedures / methods*
  • Oxygen Consumption / drug effects
  • Oxygen Consumption / physiology

Substances

  • Diuretics
  • Hypertonic Solutions
  • Mannitol