Rangel-Castillo Leonardo, Robertson Claudia S
Research Assistant, Department of Neurosurgery, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA.
Crit Care Clin. 2006 Oct;22(4):713-32; abstract ix. doi: 10.1016/j.ccc.2006.06.003.
Effective treatment of intracranial hypertension involves meticulous avoidance of factors that precipitate or aggravate increased intracranial pressure. When intracranial pressure becomes elevated, it is important to rule out new mass lesions that should be surgically evacuated. medical management of increased intracranial pressure should include sedation and paralysis, drainage of cerebrospinal fluid, and osmotherapy with either mannitol or hypertonic saline. For intracranial hypertension refractory to initial medical management, barbiturate coma, hypothermia, or decompressive craniectomy should be considered. Steroids are not indicated and may be harmful in the treatment of intracranial hypertension resulting from traumatic brain injury.
颅内高压的有效治疗需要精心避免那些会引发或加重颅内压升高的因素。当颅内压升高时，排除需要手术清除的新的占位性病变非常重要。颅内压升高的药物治疗应包括镇静和麻痹、脑脊液引流以及使用甘露醇或高渗盐水进行渗透疗法。对于初始药物治疗无效的颅内高压，应考虑巴比妥类药物昏迷、低温疗法或减压性颅骨切除术。不建议使用类固醇，且其可能对创伤性脑损伤导致的颅内高压治疗有害。
