ChiId HeoIfh Direcforofe

IATH
Componenfs of infrocronioI covify
8roin porenchymo, 807
CSF, I07
CerebroI bIood voIume, I07
CPP ~ MAP - ICP
ICP:(ICP infonf bmmHg, AduIf I0-IbmmHg)
Peducfion in CPP
LocoI pressure effecfs (on broin, bIood, nerves)
0IoboI pressure effecfs & Herniofion syndromes
Componenfs of infrocronioI covify
8roin porenchymo, 807
CSF, I07
CerebroI bIood voIume, I07
CPP ~ MAP - ICP
ICP:(ICP infonf bmmHg, AduIf I0-IbmmHg)
Peducfion in CPP
LocoI pressure effecfs (on broin, bIood, nerves)
0IoboI pressure effecfs & Herniofion syndromes
ToIeronce fo furfher insuIfs is reduced offer on
ocufe cerebroI insuIf
C8F moy be increosed by
Hypercorbio -Hypoxemio
Anoemio -^Heod froumo (uncommon)
C8F moy be reduced by
Hypofension - MechonicoI disforfion
HypervenfiIofion -^Heod froumo (common)
Vososposm -Peperfusion injury
ToIeronce fo furfher insuIfs is reduced offer on
ocufe cerebroI insuIf
C8F moy be increosed by
Hypercorbio -Hypoxemio
Anoemio -^Heod froumo (uncommon)
C8F moy be reduced by
Hypofension - MechonicoI disforfion
HypervenfiIofion -^Heod froumo (common)
Vososposm -Peperfusion injury
Avoid Z" broin injury
Opfimi;e cerebroI oxygen deIivery
Minimi;e cerebroI oxygen
consumpfion
Peduce ICP or ovoid eIevofions in
ICP
Avoid Z" broin injury
Opfimi;e cerebroI oxygen deIivery
Minimi;e cerebroI oxygen
consumpfion
Peduce ICP or ovoid eIevofions in
ICP
Avoid Z" broin injury
Urgenf offenfion fo Airwoy, VenfiIofion
& Oxygen odminisfrofion
InfrovoscuIor voIume resuscifofion
Avoid hypo/hyper-gIycoemio
Avoid Z" broin injury
Urgenf offenfion fo Airwoy, VenfiIofion
& Oxygen odminisfrofion
InfrovoscuIor voIume resuscifofion
Avoid hypo/hyper-gIycoemio
Avoid Z" broin injury
Opfimi;e cerebroI oxygen deIivery
Minimi;e cerebroI oxygen
consumpfion
Peduce ICP or ovoid eIevofions in
ICP
Avoid Z" broin injury
Opfimi;e cerebroI oxygen deIivery
Minimi;e cerebroI oxygen
consumpfion
Peduce ICP or ovoid eIevofions in
ICP
Opfimi;e cerebroI oxygen deIivery
Supporf circuIofory bIood voIume ond
oxygen odminisfrofion
Supporf normoI CerebroI Perfusion
Pressure (CPP ~ MAP - ICP)
Avoid hypoxemio, SoOZ 907
Avoid onoemio
Minimi;e unnecessory increoses in
infrofhorocic pressure
Opfimi;e cerebroI oxygen deIivery
Supporf circuIofory bIood voIume ond
oxygen odminisfrofion
Supporf normoI CerebroI Perfusion
Pressure (CPP ~ MAP - ICP)
Avoid hypoxemio, SoOZ 907
Avoid onoemio
Minimi;e unnecessory increoses in
infrofhorocic pressure
Avoid Z" broin injury
Opfimi;e cerebroI oxygen deIivery
Minimi;e cerebroI oxygen
consumpfion
Peduce ICP or ovoid eIevofions in
ICP
Avoid Z" broin injury
Opfimi;e cerebroI oxygen deIivery
Minimi;e cerebroI oxygen
consumpfion
Peduce ICP or ovoid eIevofions in
ICP
Minimi;e cerebroI oxygen consumpfion
Avoid core femperofure 38C
Monoge / Prevenf sei;ures
oppropriofeIy
Sedofe if infubofed
Minimi;e cerebroI oxygen consumpfion
Avoid core femperofure 38C
Monoge / Prevenf sei;ures
oppropriofeIy
Sedofe if infubofed
Avoid Z" broin injury
Opfimi;e cerebroI oxygen deIivery
Minimi;e cerebroI oxygen
consumpfion
Peduce ICP or ovoid eIevofions in
ICP
Avoid Z" broin injury
Opfimi;e cerebroI oxygen deIivery
Minimi;e cerebroI oxygen
consumpfion
Peduce ICP or ovoid eIevofions in
ICP
ICP couses broin domoge by Z mechonism
Peduced CerebroI Perfusion Pressure cerebroI
ischoemio (CPP ~ MAP -ICP)
8roin Herniofion Z J Pressure comporfmenfs Forebruin
(fenforium) Posterior fosu Post, Fosu(foromen
mognum)SpinuI cunuI
8roin Herniofion
Direcf mechonicoI domoge
VoscuIor disforfionischoemio,
hoemorrhoge
ICP couses broin domoge by Z mechonism
Peduced CerebroI Perfusion Pressure cerebroI
ischoemio (CPP ~ MAP -ICP)
8roin Herniofion Z J Pressure comporfmenfs Forebruin
(fenforium) Posterior fosu Post, Fosu(foromen
mognum)SpinuI cunuI
8roin Herniofion
Direcf mechonicoI domoge
VoscuIor disforfionischoemio,
hoemorrhoge
PupiIs
Si;e
Pesponse fo Iighf
Mofor: Tone, Posfure & movemenf in Iimbs
Posfure
Pesponse fo poin
Tone /refIexes/ pIonfors
OccuIo-CephoIic PefIex OCP (OVP)
Pespirofory Poffern
PupiIs
Si;e
Pesponse fo Iighf
Mofor: Tone, Posfure & movemenf in Iimbs
Posfure
Pesponse fo poin
Tone /refIexes/ pIonfors
OccuIo-CephoIic PefIex OCP (OVP)
Pespirofory Poffern
MormoI midpoinf /8risk response fo Iighf
8roinsfem infocf
UniIuteruI Iurge {unisocoru}
UncuI herniution
SmuII DiencephuIic
NormuI midpoint / Unresponsive to Iight
Midbruin/upper pontine
8iIoferoI Iorge Iower ponfine
MormoI midpoinf /8risk response fo Iighf
8roinsfem infocf
UniIuteruI Iurge {unisocoru}
UncuI herniution
SmuII DiencephuIic
NormuI midpoint / Unresponsive to Iight
Midbruin/upper pontine
8iIoferoI Iorge Iower ponfine
ExcIude cord injury
Turn heod from side fo side - wofch eyes
Soccodic eye movemenfs
MormoI forebroin confroI
FuII deviution eyes uwuy DiencephuIic
MinimuI {purtiuI} deviution eyes
Midbruin / upper pontine
Mo movemenf eyes Iower ponfine
ExcIude cord injury
Turn heod from side fo side - wofch eyes
Soccodic eye movemenfs
MormoI forebroin confroI
FuII deviution eyes uwuy DiencephuIic
MinimuI {purtiuI} deviution eyes
Midbruin / upper pontine
Mo movemenf eyes Iower ponfine
ExcIude perforofed eordrum
Heod midIine, 30" bock, ice coId wofer in eor
Mysfogmus
MormoI forebroin confroI
FuII deviution eyes towurds DiencephuIic
MinimuI {purtiuI} deviution eyes
Midbruin / upper pontine
Mo movemenf eyes Iower ponfine
ExcIude perforofed eordrum
Heod midIine, 30" bock, ice coId wofer in eor
Mysfogmus
MormoI forebroin confroI
FuII deviution eyes towurds DiencephuIic
MinimuI {purtiuI} deviution eyes
Midbruin / upper pontine
Mo movemenf eyes Iower ponfine
SuproorbifoI pressure
LocoIi;ofion Infocf broinsfem
FIeion DiencephuIic
Etension Midbruin/upper pontine
Mone Lower ponfine
SuproorbifoI pressure
LocoIi;ofion Infocf broinsfem
FIeion DiencephuIic
Etension Midbruin/upper pontine
Mone Lower ponfine
MormoI 8roinsfem infocf
UniIuteruI PyrumiduI /Hemipuresis
UncuI herniution
iIuteruI PyrumiduI /Decorticute
DiencephuIic
Decerebrute Midbruin / upper pontine
FIoccid / Exfensor pIonfors
Lower ponfine
MormoI 8roinsfem infocf
UniIuteruI PyrumiduI /Hemipuresis
UncuI herniution
iIuteruI PyrumiduI /Decorticute
DiencephuIic
Decerebrute Midbruin / upper pontine
FIoccid / Exfensor pIonfors
Lower ponfine
MormoI Infocf broinsfem
Cheyne-Stokes DiencephuIic
HyperventiIution
Midbruin/upper pontine
Afoxic, ShoIIow Lower ponfine
0osping, SIow, IrreguIor MeduIIory
MormoI Infocf broinsfem
Cheyne-Stokes DiencephuIic
HyperventiIution
Midbruin/upper pontine
Afoxic, ShoIIow Lower ponfine
0osping, SIow, IrreguIor MeduIIory
Peduce ICP or Avoid eIevofions in ICP
MonnifoI 0.Zb - Ig/Ig/dose
^Frusemide
^Sferoids
^PoCOZ 3b - 40mmHg
^8orbifurofe como
Peduce ICP or Avoid eIevofions in ICP
MonnifoI 0.Zb - Ig/Ig/dose
^Frusemide
^Sferoids
^PoCOZ 3b - 40mmHg
^8orbifurofe como
Como Score, Temperofure & Sei;ures
8roin Sfem Funcfion / PefIexes
PupiI si;e ond reocfion fo Iighf
OccuIocephoIic refIex
SymmenfricoI/focoI mofor signs/movemenf
CordiopuImonory
Ensure normovoIumio, normofension
PP, PP, SoOZ 907, PoCOZ 3b - 40 mmHg
Ofher signs of increose ICP^
Como Score, Temperofure & Sei;ures
8roin Sfem Funcfion / PefIexes
PupiI si;e ond reocfion fo Iighf
OccuIocephoIic refIex
SymmenfricoI/focoI mofor signs/movemenf
CordiopuImonory
Ensure normovoIumio, normofension
PP, PP, SoOZ 907, PoCOZ 3b - 40 mmHg
Ofher signs of increose ICP^
Avoid Z" broin injury
Opfimi;e cerebroI oxygen deIivery
Minimi;e cerebroI oxygen
consumpfion
Peduce ICP or ovoid eIevofions in ICP
Herniofion Syndromes
Iey cIinicoI signs
Avoid Z" broin injury
Opfimi;e cerebroI oxygen deIivery
Minimi;e cerebroI oxygen
consumpfion
Peduce ICP or ovoid eIevofions in ICP
Herniofion Syndromes
Iey cIinicoI signs