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INTRACRANIAL PRESSURE

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  • Normal 0 to 20 mmHg

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CEREBRAL PERFUSION PRESSURE (CPP)

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Formula: CPP = Mean Arterial Pressure (MAP) − Intracranial Pressure (ICP)

  • Infants: 40 mmHg

  • Adults: 65 mmHg

    • Changes throughout development: parallels changes in systemic blood pressure (BP); increases gradually throughout development to adult levels.

    • Consider patient's baseline BP: Baseline MAP should be considered when considering therapeutic target for CPP in setting of acute neurologic injury. A patient with baseline hypertension will need blood pressure supported to a level that approximates their baseline physiology.

    • In adults poor outcomes are associated with sustained CPP <40 mmHg.

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CEREBRAL BLOOD FLOW (CBF)

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  • Infants: 40 mL/100 g/min

  • Children (4 years): 100 mL/100 g/min

  • Children (9 years): 50 to 70 mL/100 g/min

  • Adults: 50 mL/100 g/min

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CEREBRAL METABOLIC RATE FOR OXYGEN (CMRO2)

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  • Normal: 3.0 to 3.8 mL O2/100 g brain/min

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CEREBROSPINAL FLUID (CSF)

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Normal values:

  • White blood cell count (WBC): 0 to 5

  • Total protein: 22 to 38 mg/dL

  • Glucose: 60% to 80% of serum glucose

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GLASGOW COMA SCALE (GCS)

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Table Graphic Jump Location
TABLE 38-1

Glasgow Coma Scale

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SUGGESTED READINGS

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Downard C, Hulka F, Mullins RJ,  et al. Relationship of cerebral perfusion pressure and survival in pediatric brain injured patients. J Trauma. 2000;49(4):654–658.  [PubMed: 11038082]
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Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet. 1974;304(7872):81–84.

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