Richmond Physiotherapy

1. Increased pressure INTRACRNIAL
"Swelling of the brain with edema and blood accumulates in the brain."

2. Anatomy and physiology of the brain:
* Brain the most important organ of human body.
* Protected by three protective structures;
A. bone structure of the skull
B. Meninges-Dura, arachnoid, Piamatter
C. cerebrospinal fluid.

3. Physiology of intracranial pressure:
The intracranial pressure is normal 4-15mmhg and water 50-300mmof. Skull is not a flexible structure. If the pressure of an increase of more than three compensatory decrease in two others. If more than compensation efforts increased intracranial pressure.

A. FLUX CBF;
brain injury can result from compression of the brainstem and the cerebral blood flow reduction.
Ohm's Law
CBF = (CAP-JVP) \ CVR
CAP = CAROTID blood pressure
JVP = pressure JUGLARVENOUS
CVR = resistance CEREBROVASCULAR

B. Cerebral perfusion pressure;
A surrogate clinical relevance of cerebral perfusion. CPP is defined as mean arterial pressure (MAP) minus ICP
CPP = MAP-ICP.

4. PATHOPHSIOLOGY:
edematous brain tissue cause inflammation training \ hematoma
o increase pressure in the cranial cavity
No offsetting decrease in cerebral blood flow
o cerebral blood flow
o cerebral hypoxia
o ischemia vasomotor center
Sign o CUSHING (increase of BP, pulse fall) - late sign of increased intracranial pressure suggest irreversible brain damage.

5. CAUSES:
a. abscess mass lesion
b. hematoma Extadural
C. Subdural
d. Subacutesubdural intracerebral hemorrhage
e. Coup
f. Hepatic encephalopathy.
g. Brain hernia
h. Seizures.

6. MANIFASTATION clinical
aec A. Severe headache (eg head injury, subarachnoid hemorrhage)
aec B. Confusion or decreased responsiveness
aec C. Hemiparesis
aec D. Seizers
aec e. Spontaneous ecchymosis periorbital
aec F. Bradycardia
aec G. Respiratory Depression
aec H. Contra lateral papillary dilation
aec i. Loss of gag reflex
aec J. scalelessthen glass cow coma or equal to 8
aec k. Temperature may rise
aec L. Cushing's triad: increased systolic blood pressure, pulse pressure and heart rate extended slow.
aec m. Decorticate posture or deceleration.
aec N. occasional transient elevations associated with sneezing, coughing,

Conclusions diagnosis

7. ROLE OF TOMGRAPHY calculated:
The scanner can suggest elevated ICP based on the presence of a mass lesion, midline shift. Since the monitoring of ICP is also associated with a low risk of serious complication is infection of the CNS, intracranial hemorrhage.

8. The types of monitors
A. INTRVENTRICULAR;
intraventricular monitors are considered the "gold standard" ICP monitoring catheters. They are surgically placed in the ventricular system and fixed the drainage bag and the pressure transducer with a three-way valve. It allows the treatment of certain elevated ICP by drainage of CSF.

B. intraparenchymal;
Consists of a thin cable with an optical sensor electronics or fiber tip. The device is used as the fiber optic system Camino. These monitors can be inserted directly into the brain parenchyma through a small hole drilled in the skull. It causes the ease of placement and reduce the risk of infection.

C. Subarachnoid;
subarachnoid bolts are fluid coupled systems within a hollow screw that can be placed through the skull next to the mother. The mother is then perforated, allowing th.