RT Book, Section
A1 Kernie, Steven G.
A2 Rudolph, Colin D.
A2 Rudolph, Abraham M.
A2 Lister, George E.
A2 First, Lewis R.
A2 Gershon, Anne A.
SR Print(0)
ID 6721093
T1 Chapter 111. Management of Cerebral Edema and Elevated Intracranial Pressure
T2 Rudolph's Pediatrics, 22e
YR 2011
FD 2011
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-149723-7
LK accesspediatrics.mhmedical.com/content.aspx?aid=6721093
RD 2024/04/24
AB Most  forms  of  acute  head  injury  increase  the  volume  of  the  intracranial  contents.  Cerebral  edema,  hemorrhage,  acute  hydrocephalus,  or  rapidly  growing  tumors  all  result  in  intracranial  hypertension  (see  Chapter  104  and  Table  104-5).  The  relationship  between  the  volume  increase  and  the  rise  in  intracranial  pressure  is  not  linear.  Small  volumes  can  be  accommodated  either  by  stretch,  if  the  cranial  sutures  are  still  open,  or  by  displacement  of  cerebrospinal  fluid  (CSF)  into  the  spinal  canal  (this  is  why  in  most  forms  of  intracranial  hypertension,  with  the  notable  exception  of  hydrocephalus,  the  ventricles  appear  small).  To  a  lesser  extent,  the  blood  contained  at  any  time  in  the  cerebral  vessels,  especially  the  cerebral  veins,  diminishes.  As  the  volume  increase  produced  by  the  injury  becomes  larger,  however,  the  pressure  increases  more  rapidly,  a  circumstance  that  can  be  described  as  a  volume-dependent  decrease  in  the  compliance  of  the  cranium.  Any  additional  volume  causes  a  disproportionate  elevation  in  intracranial  pressure.