Iencean St M, Ciurea A V
Neurosurgery, Hospital Prof Dr N Oblu Iasi.
J Med Life. 2008 Apr-Jun;1(2):101-7.
Intracranial hypertension (ICH) was systematized in four categories according to its aetiology and pathogenic mechanisms: parenchymatous ICH with an intrinsic cerebral cause; vascular ICH, which has its actiology in disorders of cerebral blood circulation: ICH caused by disorders of cerebro-spinal fluid dynamics and idiopathic ICH. The increase of intracranial pressure is the first to happen and then intracranial hypertension develops from this initial effect becoming symptomatic: it then acquires its individuality, surpassing the initial disease. The intracranial hypertension syndrome corresponds to the stage at which the increased intracranial pressure can be compensated and the acute form of intracranial hypertension is equivalent to a decompensated ICH syndrome. The decompensation of intracranial hypertension is a condition of instability and appears when the normal intrinsic ratio of intracranial pressure time fluctuation is changed. The essential conditions for decompensation of intracranial hypertension are: the speed of intracranial pressure increase over normal values, the highest value of abnormal intracranial pressure and the duration of high ICP values. Medical objectives are preventing ICP from exceeding 20 mm Hg and maintaining a normal cerebral blood flow. The emergency therapy is the same for the acute form but each of the four forms of ICH has a specific therapy, according to the pathogenic mechanism and if possible to aetiology.
颅内高压（ICH）根据其病因和发病机制分为四类：具有内在脑部病因的实质性ICH；血管性ICH，其病因在于脑血液循环障碍；由脑脊液动力学紊乱引起的ICH和特发性ICH。颅内压升高首先发生，然后颅内高压从这种初始效应发展而来并出现症状：它随后具有其独特性，超越了初始疾病。颅内高压综合征对应于颅内压升高可得到代偿的阶段，而急性颅内高压形式等同于失代偿性ICH综合征。颅内高压的失代偿是一种不稳定状态，当颅内压时间波动的正常内在比率发生变化时出现。颅内高压失代偿的基本条件是：颅内压超过正常值的升高速度、异常颅内压的最高值以及高颅内压值的持续时间。医学目标是防止颅内压超过20mmHg并维持正常脑血流量。急性形式的紧急治疗相同，但四种形式的ICH中的每一种都有根据发病机制以及可能的病因制定的特定治疗方法。
