Department of Neurology, Tufts University School of Medicine, Beth Israel Lahey Hospital and Medical Center, 41 Mall Road, Burlington, MA 01805, USA.
Department of Neurology, Tufts University School of Medicine, Tufts Medical Center, 800 Washington Street, Box#314, Boston, MA 02111, USA.
Neurol Clin. 2021 May;39(2):293-318. doi: 10.1016/j.ncl.2021.02.005. Epub 2021 Mar 31.
This article introduces the basic concepts of intracranial physiology and pressure dynamics. It also includes discussion of signs and symptoms and examination and radiographic findings of patients with acute cerebral herniation as a result of increased as well as decreased intracranial pressure. Current best practices regarding medical and surgical treatments and approaches to management of intracranial hypertension as well as future directions are reviewed. Lastly, there is discussion of some of the implications of critical medical illness (sepsis, liver failure, and renal failure) and treatments thereof on causation or worsening of cerebral edema, intracranial hypertension, and cerebral herniation.
本文介绍了颅内生理学和压力动力学的基本概念。它还包括讨论由于颅内压升高和降低而导致的急性脑疝患者的体征和症状以及检查和放射学发现。本文回顾了目前关于颅内压升高的医疗和手术治疗以及管理方法的最佳实践，以及未来的方向。最后，还讨论了一些严重疾病（败血症、肝功能衰竭和肾功能衰竭）及其治疗对脑水肿、颅内压升高和脑疝的病因或恶化的影响。
