Neurocritical Care Review Course-ICP and Cerebral Edema Management

Video Transcription

Video Summary

In this video, neurointensivist Dr. Rana Musavi discusses intracranial pressure (ICP) and cerebral edema management. She describes different types of cerebral edema, including vasogenic, cytotoxic, hydrostatic, and osmotic. Dr. Musavi explains the Monroe-Kelly Doctrine, which states that the volume of the intracranial vault is fixed and any increase in one compartment occurs at the expense of another. She discusses the ICP waveform and its different peaks, as well as the different morphologies of ICP waveforms. Dr. Musavi also covers cerebral auto-regulation and cerebral perfusion pressure (CPP). She explains the clinical manifestations of elevated ICP, including headache, altered mental status, emesis, and signs of cerebral herniation. Dr. Musavi further discusses the causes of elevated ICP and cerebral edema, the need for ICP monitoring, and the various methods of ICP monitoring. She also discusses the treatment options for cerebral edema, including corticosteroids, osmotic agents (such as mannitol and hypertonic saline), surgical decompression, and other interventions like sedation, hyperventilation, hypothermia, and hypertonic saline. Dr. Musavi provides an overview of the Neurocritical Care Society guidelines for managing elevated ICP, as well as a decision tree for the management of these patients.

Asset Caption

Rana Moosavi, MD

Keywords

intracranial pressure

cerebral edema

ICP waveform

cerebral auto-regulation

elevated ICP

ICP monitoring

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