Introduction

Increased intracranial pressure is a frequent complication of disorders that consume intracranial space such as brain tumors, hydrocephalus, intracranial hemorrhage, and brain swelling or edema. Although it is generally assumed that increased intacranial pressure is dangerous in its own right, extraordinary elevations of intracranial pressure may be tolerated surprisingly well by patients with pseudotumor cerebri, obstruction of the superior vena cava, and dural sinus thrombosis ( Bell_and

McC.orm.ick., .1972; Crockard. . eL, aL 1992; Cheek. . et, al 1994).

In contrast, the development of a pressure gradient between intracranial compartments is a much greater hazard than a generalized rise in intracranial tension. This gradient favors a shift of intracranial structures from the compartment of greater pressure toward the compartment of lesser pressure, and may lead to compression and distortion of structures as well as ischemic infarction of herniated tissue. If the shift occurs suddenly, symptoms will develop in an acute and fulminating manner. However, if the shift occurs gradually, there may be few outward signs of distress. Under such circumstances, neurological function may deteriorate at any time.

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