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[急性颅内高压]

[Acute intracranial hypertension].

作者信息

Gilo Arrojo F, Herrera Muñoz A, Anciones B

机构信息

Departamento de Neurología, Sanatorio Nuestra Señora del Rosario-Hospital de La Zarzuela, Madrid, España.

出版信息

Neurologia. 2010 Oct;25 Suppl 1:3-10. doi: 10.1016/S0213-4853(10)70044-X.

Abstract

Acute intracranial hypertension is a syndrome with multiple etiologies. Diagnosis and treatment must be performed urgently to save the patient's life and prevent the development of significant disabilities. The appearance of this syndrome is due to intracraincreased volumes and -in turn- the pressure of the intracranial contents, either through an increase in the physiological components (blood, cerebrospinal fluid and brain parenchyma), or through the appearance of a volume in the form of added mass. The underlying brain edema in this condition may be of several types: cytotoxic, vasogenic, interstitial, or hydrostatic. Increased intracranial pressure decreases cerebral perfusion pressure, creating a vicious cycle because of the resulting cerebral ischemia, which progressively increases cerebral blood volume by decreasing resistance and further increases intracranial pressure. Treatment depends on the etiology and will generally require medical and surgical care. Patient management is usually carried out in neurocritical units and involves intracranial pressure monitoring to guide treatment. Correction of all hemostasis disorders is also crucial to patient survival.

摘要

急性颅内高压是一种病因多样的综合征。必须紧急进行诊断和治疗,以挽救患者生命并防止出现严重残疾。该综合征的出现是由于颅内体积增加,进而导致颅内内容物压力升高,这可能是由于生理成分(血液、脑脊液和脑实质)增加,也可能是由于出现了额外的占位性肿块。这种情况下潜在的脑水肿可能有几种类型:细胞毒性、血管源性、间质性或流体静力性。颅内压升高会降低脑灌注压,由于由此导致的脑缺血而形成恶性循环,脑缺血通过降低阻力逐渐增加脑血容量,进而进一步升高颅内压。治疗取决于病因,通常需要药物和手术治疗。患者管理通常在神经重症监护病房进行,包括颅内压监测以指导治疗。纠正所有止血障碍对患者存活也至关重要。

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