Multiprofessional Critical Care Review: Adult 2024 (MCCRCA24ON)-Board Questions: Brain Emergencies and Other Intracranial Problems Q&A (Contains Ethics questions)

Board Questions: Brain Emergencies and Other Intracranial Problems Q&A (Contains Ethics questions)

Video Transcription

Video Summary

A 52-year-old woman was admitted to the ICU after a cerebral aneurysm clipping surgery. She presented with a ruptured aneurysm and subarachnoid hemorrhage. The question asks about optimizing cerebral perfusion pressure and gives four options. The correct answer is euvolemia and maintaining a mean arterial pressure (MAP) greater than 90 mmHg. This is because hypervolemia can have side effects and no benefit if the patient does not have symptoms of vasospasm. Hypervolemia with systolic blood pressure greater than 180 is not necessary at this time. Maintaining systolic blood pressure less than 120 would put the patient at risk for reduced cerebral perfusion and higher likelihood of complications. The video also discusses the debate between using mean arterial pressure (MAP) or systolic blood pressure as a guide, but generally, the neuro field follows systolic blood pressure as the main target.

Asset Caption

Andrew M Naidech, MD; Stephen M. Pastores MD, MACP, FCCP, FCCM

Keywords

ICU

cerebral aneurysm

subarachnoid hemorrhage

cerebral perfusion pressure

MAP

hypervolemia

vasospasm

systolic blood pressure

neuro field

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