Cushing’s Triad – ICP –

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Elevated intracranial pressure (ICP) is a potentially devastating complication of neurologic injury. Elevated ICP may complicate trauma, central nervous system (CNS) tumors, hydrocephalus, hepatic encephalopathy, and impaired CNS venous outflow. Successful management of patients with elevated ICP requires prompt recognition, the judicious use of invasive monitoring, and therapy directed at both reducing ICP and reversing its underlying cause.

A quick video to review the 3 components of Cushing’s Triad:
1) Hypertension (high blood pressure)
2) Bradycardia (slow heart rate)
3) Bradypnea (slow breathing rate)

In summary, the major causes of increased intracranial pressure include:
– Intracranial mass lesions (eg, tumor, hematoma)
– Cerebral edema (such as in acute hypoxic ischemic encephalopathy, large cerebral infarction, severe traumatic brain injury)
– Increased cerebrospinal fluid (CSF) production, eg, choroid plexus papilloma
– Decreased CSF absorption, eg, arachnoid granulation adhesions after bacterial meningitis
– Obstructive hydrocephalus
– Obstruction of venous outflow, eg, venous sinus thrombosis, jugular vein compression, neck surgery
– Idiopathic intracranial hypertension (pseudotumor cerebri)

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