![]() Neurosurgery: The Scientific Basis of Clinical Practice, 3rd ed. Pathophysiology of cerebrospinal fluid circulation. Cerebrospinal fluid physiology and the management of increased intracranial pressure. Formation and absorption of cerebrospinal fluid in man. Recent research into the nature of cerebrospinal fluid formation and absorption. Volume regulation of the brain tissue: a survey. Transmission of increased intracranial pressure: I. Langfitt TW, Weinstein JD, Kassell NF, et al. Intrahemispheric gradients of brain tissue pressure in patients with brain tumors. Brain tissue pressure gradients are dependent upon a normal spinal subarachnoid space. Regional brain tissue pressure gradients created by expanding extradural temporal mass lesion. Magnetic resonance imaging measurements and clinical changes accompanying transtentorial and foramen magnum brain herniation. Reich JB, Sierra J, Camp W, Zanzonico P, Deck MDF, Plum F. Cerebral vasomotor paralysis produced by intracranial hypertension. Pathophysiology and pathology of elevated intracranial pressure. Long-term outcome after medical reversal of transtentorial herniation in patients with supratentorial mass lesions. Qureshi AI, Geocadin RG, Suarez JI, Ulatowski JA. This process is experimental and the keywords may be updated as the learning algorithm improves. These keywords were added by machine and not by the authors. There are insufficient hard data to guide those in the process of gaining that experience. Practice is inevitably the product of the idiosyncratic experience of each individual intensivist. Owing in part to the limits of our current technology, but also to a regrettable dearth of clinical trials in the field, current clinical practice is based on a conceptual understanding of underlying pathophysiology but backed by insufficient systematic research with patients. Unfortunately, too little is yet known to predict exactly which interventions will be effective in exactly which disease states exactly when. Although our armamentarium remains fairly limited, we may begin to envision its use on a rational, pathophysiologically grounded basis. There have been many advances in our understanding of the physiology of intracranial dynamics. The astute clinician can improve patients’ outcomes if judicious steps are taken at the right time (1). Intracranial hypertension can be a hyperacute emergency that must be reversed if profound morbidity or death are to be avoided. Elevated intracranial pressure (ICP) is a relatively common clinical problem, potentially encountered daily in any neurocritical care unit. ![]()
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